Expression of MBNL2 and Other Genes Associated with Bladder Cancer Progression

ABSTRACT

Disclosed are methods for predicting the risk of bladder cancer progression, including death from bladder cancer by determining gene expression levels of FABP4 and MBNL2 or other markers where increased levels correlate with lack of progression of the subject&#39;s bladder cancer, and decreased levels correlate with progression or death from bladder cancer, and/or determining gene expression levels of COL4A1, UBE2C, BIRC5, COL18A1, KPNA2, MSN, ACTA2, and/or CDC25B or other markers where increased levels correlate with progression of the subject&#39;s bladder cancer or death from it, and decreased levels correlate with lack of progression of bladder cancer.

RELATED APPLICATIONS

This application is a continuation-in-part of U.S. patent application Ser. No. 12/180,321, filed Jul. 5, 2008, and incorporated by reference herein, which is a continuation of U.S. patent application Ser. No. 10/533,547 filed Nov. 16, 2005, which is a US National Phase application of PCT/DK03/00750 filed Nov. 3, 2003.

SEQUENCE LISTING

This application contains a Sequence Listing which has been submitted in ASCII format via EFS-Web and is hereby incorporated by reference in its entirety. Said ASCII copy, created on Nov. 28, 2011, is named SORGE321.txt and is 43,073 bytes in size.

FIELD OF THE INVENTION

The invention relates to predicting the prognosis of bladder cancer from gene expression levels.

BACKGROUND

In industrialized countries, urinary bladder cancer is the fourth most common malignancy in males, and the fifth most common neoplasm overall. The disease basically takes two different courses: one where patients have multiple recurrences of superficial tumors (Ta and T1), and one which progresses to a muscle invasive form (T2-) which can lead to metastasis. About 5-10% of patients with Ta tumors and 20-30% of the patients with T1 tumors will eventually develop a higher stage tumor (Wolf, H. et al. Bladder tumors treated natural history. Prog Clin Biol Res 221, 223-55 (1986).). Patients with superficial bladder tumors represent 75% of all bladder cancer patients. No approved clinically useful markers separating such patients by likelihood of progression exist.

It is believed that patients presenting isolated or concomitant carcinoma in situ (CIS) lesions have a higher risk of disease progression to a muscle invasive stage. The CIS lesions may have a widespread manifestation in the bladder (field disease) and are believed to be the most common precursors of invasive carcinomas (Spruck, C. H., et al. Two molecular pathways to transitional cell carcinoma of the bladder. Cancer Res, 54: 784-788, 1994; Rosin, M. P. et al. Partial allelotype of carcinoma in situ of the human bladder. Cancer Res, 55: 5213-5216, 1995). Generally, it is known that class T1 tumors have a higher risk of further progression than class Ta tumors. However, it is often difficult to differentiate Ta from T1 stage tumors, and the two stages are often confused. The ability to predict which tumors are likely to recur or progress would have great impact on the clinical management of patients with superficial disease, as it would be possible to treat high-risk patients more aggressively (e.g. with radical cystectomy or adjuvant therapy).

Although many prognostic markers have been investigated, the most important prognostic factors are still disease stage, dysplasia grade, and especially the presence of areas with CIS (Anderstrom, C., et al., The significance of lamina propria invasion on the prognosis of patients with bladder tumors. J Urol, 124: 23-26, 1980; Cummings, K. B. Carcinoma of the bladder: predictors. Cancer, 45: 1849-1855, 1980; Cheng, L. et al. Survival of patients with carcinoma in situ of the urinary bladder. Cancer, 85: 2469-2474, 1999.). The current standard for detection of CIS is urine cytology and histopathologic analysis of a set of selected site biopsies removed during routine cystoscopy examinations; however these procedures are not sufficiently sensitive. Implementing routine cystoscopy examinations with 5-ALA fluorescence imaging of the tumors and pre-cancerous lesions (CIS lesions and moderate dysplasia lesions) may increase the sensitivity, of the procedure (Kriegmair, M. et al., Early clinical experience with 5-aminolevulinic acid for the photodynamic therapy of superficial bladder cancer. Br J Urol, 77: 667-671, 1996). However, this screening is not yet routine.

Monitoring of gene expression levels may be used to find markers whose elevated expression correlates either: with bladder cancer progression or death from bladder cancer; or, with no progression or death. Further, once such markers are found, one may combine the gene expression levels of such markers into sets or signatures, which, in combination, may indicate the likelihood of progression or death more reliably than when monitoring them separately.

Gene expression levels can be monitored by assaying a subject RNA using a method or process that detects a signal coming from the RNA molecules. Examples of methods or processes used to monitor gene expression include nucleic acid hybridization, quantitative polymerase chain reaction (or other nucleic acid replication reactions), nucleic acid sequencing, protein product detection, and visible light or ultra-violet light spectrophotometry or diffraction. Such methods can utilize fluorescent dyes, radioactive tracers, enzymatic reporters, chemical reaction products, or other means of reporting the amounts or concentrations of nucleic acid molecules. Gene expression levels can be monitored by first reverse transcribing the mRNA from a subject's sample to cDNA, then amplifying the cDNA using polymerase chain reaction (PCR).

SUMMARY

The inventions described and claimed herein have many attributes and embodiments including, but not limited to, those set forth or described or referenced in this Summary. It is not intended to be all-inclusive and the inventions described and claimed herein are not limited to or by the features or embodiments identified in this Summary, which is included for purposes of illustration only and not restriction.

The invention relates to determining expression levels of certain markers associated with progression or death from bladder cancer. More particularly, expression levels of markers MBNL2, FABP4, UBE2C, and BIRC5 have been associated with progression or death from bladder cancer. Expression levels of these genes can be combined with expression levels of other genes associated with bladder cancer (including with other genes associated with progression, i.e., certain genes in Table A) in a gene signature. The signature may in some cases provide a more accurate indication of progression or death from bladder cancer, or non-progression, than any gene in isolation. A score can be obtained from a signature, and scores can be compared to known or control values to provide predictive information.

Detection of expression levels of some or all of these markers in early-stage bladder cancer patients can be used to predict patient outcomes and/or tailor treatments. Expression levels can be determined by measuring a gene product of a particular gene in a sample. The products include pre-mRNA, mRNA, cDNA transcribed from the mRNA, and protein translated from mRNA. A preferred measurement technique includes RT-PCR (quantitative “real time” polymerase chain reaction) of cDNA reverse-transcribed from the mRNA present in a subject's sample. Expression arrays, nucleic acid sequencing, fluorescent nucleic acid dyes and/or chelators can also be used to determine cDNA levels, as well as techniques for assaying for particular protein products, including ELISA, Western Blotting, and enzyme assays.

In a preferred embodiment, the relative amount of one or more of the markers is determined relative to one or more other markers in the assay. The relative amount of one or more of the markers can also be determined relative to a standard expression level for each such marker.

Furthermore, the invention relates to a method of determining the likelihood of progression or death from bladder cancer, comprising determining the expression level of at least one of the markers MBNL2, FABP4, UBE2C, and/or BIRC5 in a human tissue sample, and wherein one can also determine the expression level of at least one other gene in the group of genes Nos. 1 to 562 in Table A, and correlating the expression level of the assessed genes to at least one standard level of expression of such genes to determine the likelihood of bladder cancer progression or death therefrom. The human cell sample may be taken from bladder tissue, and the method may be independent of the proportion of submucosal, muscle, or connective tissue cells present.

The invention further relates to a method for reducing tumorigenicity or malignancy comprising contacting a tumor cell with at least one of the genes MBNL2, FABP4, UBE2C, and/or BIRC5 so as to permit introducing said at least one gene into the tumor cell in a manner allowing expression of said gene(s). Alternatively, the method for reducing tumorigenicity or malignancy can include obtaining at least one nucleotide probe capable of hybridizing with at least one of the genes MBNL2, FABP4, UBE2C, and/or BIRC5 and introducing said at least one nucleotide probe into the tumor cell in a manner allowing the probe to hybridize to the at least one gene, thereby inhibiting expression of said at least one gene.

In a further aspect the invention relates to a method for producing antibodies against an expression product of a cell from a biological tissue, said method comprising the steps of obtaining expression product(s) from at least one of the genes MBNL2, FABP4, UBE2C, and/or BIRC5, immunizing a mammal with said expression product(s) obtaining antibodies against the expression product. The antibodies produced may be used for producing a pharmaceutical composition. Further, the invention relates to a vaccine capable of eliciting an immune response against at least one expression product from at least one gene said gene being expressed as defined above. The invention furthermore relates to the use of any of the methods discussed above for producing an assay for diagnosing a biological condition in animal tissue. Also, the invention relates to the use of a peptide as defined above as an expression product and/or the use of a gene as defined above and/or the use of a probe as defined above for preparation of a pharmaceutical composition for the treatment of a biological condition in animal tissue.

As noted above, expression levels for genes including MBNL2, FABP4, UBE2C, and/or BIRC5 as well as the genes COL18A1, COL4A1, ACTA2, MSN and KPNA2 can be determined from monitoring expression products, including those expression products represented by or relating to the Sequence ID Number and listing herein for each of the respective genes. Other sequences which can be monitored to determine expression levels are listed on the NCBI database—and have been publicly available there since the earliest priority date of this application. Again, it is noted that some or all of the expression levels of some or all of these genes can be combined to give a score, which can in turn be used in predicting likelihood of bladder cancer progression or death from bladder cancer.

As is well known in the art, in the sequences identified herein, the first exon includes sequence upstream of the ATG start codon and the final exon includes information downstream of the stop codon including the polyA tail. That is how the mRNA appears after the processing which removes the introns from the transcribed DNA sequence. Within this mRNA sequence is the region known as the CDS, or coding DNA sequence, which goes from start to stop codon. It is only the region from start to stop codon that gets translated into protein, but the mRNA contains both 5′ (upstream) and 3′ (downstream) untranslated regions and the mRNA sequences are generally what are shown in the NCBI Nucleotide database of sequences.

DRAWINGS Description of Figures

FIG. 1: Hierarchical cluster analysis of tumor samples based on 3,197 genes that show large variation across all tumor samples. Samples with progression are marked “Progression”

FIG. 2. Cross-validation performance using from 1 to 200 genes.

FIG. 3. Hierarchical cluster analysis of the metachronous tumor samples. Tightly clustering tumors of different stages from the same patients are indicated with a square bracket to their right.

FIG. 4A. Two-way hierarchical clustering and multidimensional scaling analysis of gene expression data from 40 bladder tumor biopsies. Tumor cluster dendrogram based on the 1767 gene-set. CIS annotations following the sample names indicate concomitant carcinoma in situ. Tumor recurrence rates are shown to the right of the dendrogram as + and ++ indicating moderate and high recurrence rates, respectively, while no sign indicates no or moderate recurrence.

FIG. 4B. Two-way hierarchical clustering and multidimensional scaling analysis of gene expression data from 40 bladder tumor biopsies. Tumor cluster dendrogram based on 88 cancer related genes.

FIG. 4C. Plot of multidimensional scaling analysis of the 40 tumors based on the 1767 gene set.

FIG. 5. Molecular classification of tumor samples using 80 predictive genes in each cross-validation loop. Each classification is based on the closeness to the mean in the three classes. Samples marked with * were not used to build the classifier. The scale indicates the distance from the samples to the classes in the classifier, measured in weighted squared Euclidean distance.

FIG. 6. Number of classification errors vs. number of genes used in cross-validation loops.

FIG. 7. Number of prediction errors vs. number of genes used in cross-validation loops.

FIG. 8. Hierarchical cluster analysis of the gene expression in 41 TCC, 9 normal samples and 10 samples from cystectomy specimens with CIS lesions. 8A. Cluster dendrogram of all 41 TCC biopsies based on the expression of 5,491 genes. 8B. Cluster dendrogram of all superficial TCC biopsies based on the expression of 5,252 genes.

FIG. 9. Cross validation performance using all samples.

FIG. 10. Cross validation performance using half of the samples.

SEQUENCE LISTING GUIDE

The sequences listed below correspond to one complete gene sequence of one isoform of the designated genes, following transcription processing, as posted and available on the NCBI Nucleotide database.

SEQ ID NO. 1: UBE2C also known as UBCH10 (see FIGS. 7c & 8c in Ser. No. 12/180,321)

SEQ ID NO. 2: MBNL2 (see FIG. 4a in Ser. No. 12/180,321 and Gene No. 295 in Table A)

SEQ ID NO. 3: FABP4 (see FIG. 14a in Ser. No. 12/180,321 and Gene No. 467 in Table A)

SEQ ID NO. 4: BIRC5 (see FIG. 4a in Ser. No. 12/180,321 and Gene No. 437 in Table A)

SEQ ID NO. 5: COL18A1 (see FIGS. 7g and 8g in Ser. No. 12/180,321).

SEQ ID NO. 6: COL4A1 (see FIG. 8h in Ser. No. 12/180,321)

SEQ ID NO. 7: ACTA2 (see FIG. 8h in Ser. No. 12/180,321)

SEQ ID NO. 8: MSN (see FIGS. 7g, 8g & 14a in Ser. No. 12/180,321)

SEQ ID NO. 9: KPNA2 (see FIG. 14a in Ser. No. 12/180,321)

SEQ ID NO. 10: CDC25B (see Gene No. 104 in Table A)

DETAILED DESCRIPTION

“Control” refers to a bladder cancer sample or pool of bladder cancer samples that are used for comparison with a bladder cancer sample from a patient. In certain instances, a control can be a normal non-cancerous sample.

“Cut-off score” refers to a score associated with a signature allowing classification of patients into different prognostic or treatment groups. There may be more than one cut-off score for a diagnostic or prognostic test. For example, a first, lower cut-off score may be useful to separate patients into groups appropriate for treatment options A versus B; and a second, higher cut-off score may be useful to separate patients into groups appropriate for treatment options B versus C. The cut-off score for a signature may be determined from or with reference to the relative expression levels or the standard expression levels for the gene products in the signature, or by other means or from other references.

“Cut-off value” refers to an expression level of a gene product allowing classification of patients into different prognostic or treatment groups. There may be more than one cut-off value for a diagnostic or prognostic test. For example, a first, lower cut-off value may be useful to separate patients into groups appropriate for treatment options A versus B; and a second, higher cut-off value may be useful to separate patients into groups appropriate for treatment options B versus C. The cut-off value for any gene product may be determined from or with reference to the relative expression level or the standard expression level for that gene product, or by other means or from other reference.

“Expression level” when used in connection with gene expression means the total quantities of a gene expressed, or the quantities expressed per unit time or per unit volume.

“Favorable Markers” is used synonymously with protective markers.

“Gene” refers to a genomic DNA sequence, including a marker sequence. Genes may be expressed at different levels in cells, or not expressed at all. A “gene” may be part of a genomic DNA sequence that is transcribed into RNA molecules. Such RNA molecules may or may not be spliced into mRNA and/or translated into protein. “Gene” as used herein may be any part or several parts of a genomic DNA sequence that may be transcribed into RNA molecules. The genes/markers UBE2C, MBNL2, FABP4, BIRC5, COL18A1, COL4A1, ACTA2, MSN, KPNA2 and CDC25B are designations for these genes as referenced in the US National Institutes of Health, National Center for Biotechnology Information (NCBI) database and publicly available since the earliest priority date of this application, and the sequences corresponding to each of the genes in the Sequence Listing Guide above are the complete sequence of one isoform of the designated genes, following transcription processing, and thus; can be used in determination of the quantity of a particular expression product.

“Harmful markers” are indicator genes or indicator gene products for which increased expression levels indicate a less favorable prognosis, i.e., increased expression levels correlate with higher risk of progression; and decreased expression levels correlate with lower risk of progression.

“Marker” refers to a gene or gene product associated with bladder cancer or with bladder cancer progression, including, but not limited to, MBNL2, FABP4, UBE2C, and BIRC5. “Marker” is used synonymously with indicator gene or indicator gene product.

“Non-progression” (or “non-progressors’) in reference to bladder cancer or bladder cancer patients refers to lack of progression from earlier stages or lower grades to later stages or higher grades; e.g., it can refer to progression from either bladder cancer stage Ta or T1, including stage Ta or T1 without carcinoma in situ (“CIS”), to: (i) CIS and/or any of stages 12 through T4, or (ii) death from bladder cancer.

“Progression” (or “progressors”) in reference to bladder cancer or bladder cancer patients refers to progression from earlier stages or lower grades to later stages or higher grades; e.g., it can refer to progression from either bladder cancer stage Ta or T1, including stage Ta or T1 without carcinoma in situ (“CIS”), to: (i) CIS and/or any of stages T2 through T4, or (ii) death from bladder cancer.

“Protective markers” are indicator genes or indicator gene products for which increased expression levels indicate a more favorable prognosis, i.e., increased expression levels correlate with non-progression; and decreased expression levels correlate with risk of progression.

“Score” refers to the result of a mathematical computation using one or more marker expression levels in a signature, typically treating the unfavorable marker level(s) as a group and the favorable marker level(s) as a group. Expression levels for markers may be combined using various mathematical functions. For example, determining score may involve computing the mean, median, or mode of certain expression levels; or involve computing one or more ratios, products, sums, differences, logarithms, exponents, and/or other mathematical functions. It is contemplated that in some cases only one gene or marker will be present in a group for which a score is determined.

“Signature” refers to sets of markers.

“Standard expression level” refers to the expression level of one or more gene product(s) in a standard situation such as an expression level associated with non-progression of bladder cancer or an expression level associated with progression of bladder cancer.

“Unfavorable markers” is used synonymously with harmful markers.

This invention relates to the predicting the likelihood of progression or non-progression of bladder cancer by determining the relative expression level of one or more of the markers MBNL2, FABP4, UBE2C, and BIRC5 and/or comparing the expression level, or levels, to standard expression level(s) for these markers. The comparison can include determining a cut-off value for an individual marker or a cut-off score such as for a signature including these markers, and determining the relationship of marker expression levels to the cut-off value, or comparing the signature's score to the cut-off score. For some markers, an increased relative expression level may indicate an increased risk of progression, and for other markers, a reduced risk of progression. For some markers, a decreased relative expression level may indicate an increased risk of progression, and for other markers, a reduced risk of progression.

Expression levels of other genes or markers including COL18A1, COL4A1, ACTA2, MSN, and KPNA2 can also be determined and used in predicting an increase or decrease in risk of bladder cancer progression. Similarly, in forming signatures, such additional markers or additional genes can be included in the signature, and used to determine a score, which can be compared to a cut-off score to determine risk of progression.

In one embodiment of the invention, signatures comprising two or more markers significantly correlated with clinically determined progression or non-progression of bladder cancer can be used to determine risk of bladder cancer progression along a continuum. Some patients will be classified as at high risk of progression, others will be identified as at intermediate risk and still others as at low risk of progression. Each of these classifications will have clinical consequences. For example high risk patients may be monitored for bladder cancer recurrence, metastasis or other form of progression more frequently; they may also be good candidates for cystectomy or other more aggressive treatment options. Low risk patients, may for example be monitored at slightly greater intervals, for example every four months rather than every two months. Intermediate risk patients might follow a more standard treatment and monitoring protocol because the signature would not place them into either high or low risk categories distinctly. The methods for assessing the risk of progression from the signature can be using Ct values or ROC (Receiver Operating Characteristic) curves or various other statistical analyses. Non-limiting examples of such analysis methods are Pearson correlation, Wilcoxon signed rank test, and Cox regression analysis.

In certain embodiments it may be useful to assign different significance or weight to particular harmful and protective markers in a signature used to make a determination about an individual's prognosis in a disease. For example, a signature comprising markers significantly correlated with risk of bladder cancer progression, may contain one or more markers that are even more significantly correlated with risk of progression (Note: this can either be a very low risk of progression as with protective markers or a high risk of progression as with harmful markers) than the other markers in the signature. Any marker(s) showing increased correlation with risk of bladder cancer progression compared to other markers in the signature could be weighted more heavily than those other markers in a manner that reflects their increased statistical correlation with the clinical outcome. One example of how this might be achieved is to look at a group of patients whose bladder cancer progressed and a second group of patients whose bladder cancer did not progress. Then for each group of patients weight the preferred protective markers, for example MBNL2 and/or FABP4; and weight the preferred harmful markers, for example UBE2C and/or including any of BIRC5, COL18A1, COL4A1, KPNA2, MSN, ACTA2 and CDC25B. In each instance the objective of the weighting would be to achieve the best correlation with risk of bladder cancer progression in each patient group; high risk and low risk. The weights may be adjusted in many ways depending on the particular clinical needs at the time of assessment. For example, one may adjust the weights to reduce the number of patients who are likely to progress being falsely categorized as at low risk of progression. Alternatively, the weights can be adjusted to reduce the number of patients who are unlikely to progress being falsely categorized as at high risk of progression. It will be apparent to one of skill in the art that other clinical concerns could affect how particular markers are weighted and these methods are all included in this embodiment.

It is contemplated that one might use a Cox regression analysis to determine the independent contribution of the expression level of each marker in a signature to overall likelihood of bladder cancer progression. Each marker in a signature may contribute to the overall risk of progression differently or be weighted differently. One could use the Cox covariate regression analysis to determine the coefficient (i.e. weight) for each marker in the signature and this coefficient may be multiplied by the measure of the expression level for a particular marker such as, but not limited to, a Ct value to determine a score for the signature where individual markers are evaluated based upon the significance of the correlation of the expression levels for each individual marker to the risk of progression. In a signature composed of six markers, where some are protective and some are harmful, the calculation for score might look like:

Score=((a*Ct(PM1)+b*Ct(PM2)+c*Ct(PM3))/3)−((d*Ct(HM1)+e*Ct(HM2)+f*Ct(HM3))/3)

Or in a preferred alternative, one could calculate score by dividing the sum of the weighted Ct's (or other measure of expression levels) for the protective markers by the sum of the weights for each protective marker in the signature and then dividing the sum of the weighted Ct's (or other measure of expression levels) for the harmful markers by the sum of the weights for each harmful marker in the signature. Finally, you would subtract the score calculated for the harmful markers from the score calculated for the protective markers as shown below. Such a calculation would then allow one to subtract out much of the possible sources of noise in determining the expression levels for the protective and harmful markers of the signature.

Score=((a*Ct(PM1)+b*Ct(PM2)+c*Ct(PM3))/Σ(a,b,c))−((d*Ct(HM1)+e*Ct(HM2)+f*Ct(HM3))/Σ(d,e,f))

Where a-f are the coefficients (i.e. weights) determined by regression analysis;

PM1, PM2 and PM3 are protective markers; and

HM1, HM2 and HM3 are harmful markers.

Other statistical methods or analysis methods could be used to determine coefficients or weights for each marker. Other methods than determining Ct values could be used to determine the expression levels for each marker. The above calculation for score is just one possible method for factoring in the possible differences in significance for each marker in a signature. Other methods will occur to those of skill in the art and are incorporated herein. It will be obvious that each marker in the progression signature may be equally significant in determining likelihood of progression and thus all coefficients a-f will be the same.

The following table A shows the genes whose expression level can reflect likelihood of progression. The genes marked as stage, progression and CIS in the classifier column of Table A are associated with bladder cancer progression. Whenever a gene is referenced herein by a gene number, the number refers to the genes of Table A.

TABLE A Unigene Gene # GeneChip Probeset Build Unigene description Classifier 1 HUGeneFL AB000220_at 168 Hs.171921 sema domain, immunoglobulin domain stage (Ig), short basic domain, secreted, (semaphorin) 3C 2 HUGeneFL AF000231_at 168 Hs.75618 RAB11A, member RAS oncogene family stage 3 HUGeneFL D10922_s_at 168 Hs.99855 formyl peptide receptor-like 1 stage 4 HUGeneFL D10925_at 168 Hs.301921 chemokine (C-C motif) receptor 1 stage 5 HUGeneFL D11086_at 168 Hs.84 interleukin 2 receptor, gamma (severe stage combined immunodeficiency) 6 HUGeneFL D11151_at 168 Hs.211202 endothelin receptor type A stage 7 HUGeneFL D13435_at 168 Hs.426142 phosphatidylinositol glycan, class F stage 8 HUGeneFL D13666_s_at 168 Hs.136348 osteoblast specific factor 2 (fasciclin I-like) stage 9 HUGeneFL D14520_at 168 Hs.84728 Kruppel-like factor 5 (intestinal) stage 10 HUGeneFL D21878_at 168 Hs.169998 bone marrow stromal cell antigen 1 stage 11 HUGeneFL D26443_at 168 Hs.371369 solute carrier family 1 (glial high affinity stage glutamate transporter), member 3 12 HUGeneFL D42046_at 168 Hs.194665 DNA2 DNA replication helicase 2-like stage (yeast) 13 HUGeneFL D45370_at 168 Hs.74120 adipose specific 2 stage 14 HUGeneFL D49372_s_at 168 Hs.54460 chemokine (C-C motif) ligand 11 stage 15 HUGeneFL D50495_at 168 Hs.224397 transcription elongation factor A (SII), 2 stage 16 HUGeneFL D63135_at 168 Hs.27935 tweety homolog 2 (Drosophila) stage 17 HUGeneFL D64053_at 168 Hs.198288 protein tyrosine phosphatase, receptor stage type, R 18 HUGeneFL D83920_at 168 Hs.440898 ficolin (collagen/fibrinogen domain stage containing) 1 19 HUGeneFL D85131_s_at 168 Hs.433881 MYC-associated zinc finger protein stage (purine-binding transcription factor) 20 HUGeneFL D86062_s_at 168 Hs.413482 chromosome 21 open reading frame 33 stage 21 HUGeneFL D86479_at 168 Hs.439463 AE binding protein 1 stage 22 HUGeneFL D86957_at 168 Hs.307944 likely ortholog of mouse septin 8 stage 23 HUGeneFL D86959_at 168 Hs.105751 Ste20-related serine/threonine kinase stage 24 HUGeneFL D86976_at 168 Hs.196914 minor histocompatibility antigen HA-1 stage 25 HUGeneFL D87433_at 168 Hs.301989 stabilin 1 stage 26 HUGeneFL D87443_at 168 Hs.409862 sorting nexin 19 stage 27 HUGeneFL D87682_at 168 Hs.134792 KIAA0241 protein stage 28 HUGeneFL D89077_at 168 Hs.75367 Src-like-adaptor stage 29 HUGeneFL D89377_at 168 Hs.89404 msh homeo box homolog 2 (Drosophila) stage 30 HUGeneFL D90279_s_at 168 Hs.433695 collagen, type V, alpha 1 stage 31 HUGeneFL HG1996- 168 — — stage HT2044_at 32 HUGeneFL HG2090- 168 — — stage HT2152_s_at 33 HUGeneFL HG2463- 168 — — stage HT2559_at 34 HUGeneFL HG3044- 168 — — stage HT3742_s_at 35 HUGeneFL HG3187- 168 — — stage HT3366_s_at 36 HUGeneFL HG3342- 168 — — stage HT3519_s_at 37 HUGeneFL HG371- 168 — — stage HT26388_s_at 38 HUGeneFL HG4069- 168 — — stage HT4339_s_at 39 HUGeneFL HG67-HT67_f_at 168 — — stage 40 HUGeneFL HG907-HT907_at 168 — — stage 41 HUGeneFL J02871_s_at 168 Hs.436317 cytochrome P450, family 4, subfamily B, stage polypeptide 1 42 HUGeneFL J03040_at 168 Hs.111779 secreted protein, acidic, cysteine-rich stage (osteonectin) 43 HUGeneFL J03060_at 168 — — stage 44 HUGeneFL J03068_at 168 — — stage 45 HUGeneFL J03241_s_at 168 Hs.2025 transforming growth factor, beta 3 stage 46 HUGeneFL J03278_at 168 Hs.307783 platelet-derived growth factor receptor, stage beta polypeptide 47 HUGeneFL J03909_at 168 — — stage 48 HUGeneFL J03925_at 168 Hs.172631 integrin, alpha M (complement stage component receptor 3, alpha; also known as CD11b (p170), macrophage antigen alpha polypeptide) 49 HUGeneFL J04056_at 168 Hs.88778 carbonyl reductase 1 stage 50 HUGeneFL J04058_at 168 Hs.169919 electron-transfer-flavoprotein, alpha stage polypeptide (glutaric aciduria II) 51 HUGeneFL J04130_s_at 168 Hs.75703 chemokine (C-C motif) ligand 4 stage 52 HUGeneFL J04152_rna1_s_at 168 — — stage 53 HUGeneFL J04162_at 168 Hs.372679 Fc fragment of IgG, low affinity IIIa, stage receptor for (CD16) 54 HUGeneFL J04456_at 168 Hs.407909 lectin, galactoside-binding, soluble, 1 stage (galectin 1) 55 HUGeneFL J05032_at 168 Hs.32393 aspartyl-tRNA synthetase stage 56 HUGeneFL J05070_at 168 Hs.151738 matrix metalloproteinase 9 (gelatinase B, stage 92 kDa gelatinase, 92 kDa type IV collagenase) 57 HUGeneFL J05448_at 168 Hs.79402 polymerase (RNA) II (DNA directed) stage polypeptide C, 33 kDa 58 HUGeneFL K01396_at 168 Hs.297681 serine (or cysteine) proteinase inhibitor, stage clade A (alpha-1 antiproteinase, antitrypsin), member 1 59 HUGeneFL K03430_at 168 — — stage 60 HUGeneFL L06797_s_at 168 Hs.421986 chemokine (C—X—C motif) receptor 4 stage 61 HUGeneFL L10343_at 168 Hs.112341 protease inhibitor 3, skin-derived (SKALP) stage 62 HUGeneFL L13391_at 168 Hs.78944 regulator of G-protein signalling 2, 24 kDa stage 63 HUGeneFL L13698_at 168 Hs.65029 growth arrest-specific 1 stage 64 HUGeneFL L13720_at 168 Hs.437710 growth arrest-specific 6 stage 65 HUGeneFL L13923_at 168 Hs.750 fibrillin 1 (Marfan syndrome) stage 66 HUGeneFL L15409_at 168 Hs.421597 von Hippel-Lindau syndrome stage 67 HUGeneFL L17325_at 168 Hs.195825 RNA binding protein with multiple splicing stage 68 HUGeneFL L19872_at 168 Hs.170087 aryl hydrocarbon receptor stage 69 HUGeneFL L27476_at 168 Hs.75608 tight junction protein 2 (zona occludens 2) stage 70 HUGeneFL L33799_at 168 Hs.202097 procollagen C-endopeptidase enhancer stage 71 HUGeneFL L40388_at 168 Hs.30212 thyroid receptor interacting protein 15 stage 72 HUGeneFL L40904_at 168 Hs.387667 peroxisome proliferative activated stage receptor, gamma 73 HUGeneFL L41919_rna1_at 168 — — stage 74 HUGeneFL M11433_at 168 Hs.101850 retinol binding protein 1, cellular stage 75 HUGeneFL M11718_at 168 Hs.283393 collagen, type V, alpha 2 stage 76 HUGeneFL M12125_at 168 Hs.300772 tropomyosin 2 (beta) stage 77 HUGeneFL M14218_at 168 Hs.442047 argininosuccinate lyase stage 78 HUGeneFL M15395_at 168 Hs.375957 integrin, beta 2 (antigen CD18 (p95), stage lymphocyte function-associated antigen 1; macrophage antigen 1 (mac-1) beta subunit) 79 HUGeneFL M16591_s_at 168 Hs.89555 hemopoietic cell kinase stage 80 HUGeneFL M17219_at 168 Hs.203862 guanine nucleotide binding protein (G stage protein), alpha inhibiting activity polypeptide 1 81 HUGeneFL M20530_at 168 — — stage 82 HUGeneFL M23178_s_at 168 Hs.73817 chemokine (C-C motif) ligand 3 stage 83 HUGeneFL M28130_rna1_s_at 168 — — stage 84 HUGeneFL M29550_at 168 Hs.187543 protein phosphatase 3 (formerly 2B), stage catalytic subunit, beta isoform (calcineurin A beta) 85 HUGeneFL M31165_at 168 Hs.407546 tumor necrosis factor, alpha-induced stage protein 6 86 HUGeneFL M32011_at 168 Hs.949 neutrophil cytosolic factor 2 (65 kDa, stage chronic granulomatous disease, autosomal 2) 87 HUGeneFL M33195_at 168 Hs.433300 Fc fragment of IgE, high affinity I, receptor stage for; gamma polypeptide 88 HUGeneFL M37033_at 168 Hs.443057 CD53 antigen stage 89 HUGeneFL M37766_at 168 Hs.901 CD48 antigen (B-cell membrane protein) stage 90 HUGeneFL M55998_s_at 168 Hs.172928 collagen, type I, alpha 1 stage 91 HUGeneFL M57731_s_at 168 Hs.75765 chemokine (C—X—C motif) ligand 2 stage 92 HUGeneFL M62840_at 168 Hs.82542 acyloxyacyl hydrolase (neutrophil) stage 93 HUGeneFL M63262_at 168 — — stage 94 HUGeneFL M68840_at 168 Hs.183109 monoamine oxidase A stage 95 HUGeneFL M69203_s_at 168 Hs.75703 chemokine (C-C motif) ligand 4 stage 96 HUGeneFL M72885_rna1_s_at 168 — — stage 97 HUGeneFL M77349_at 168 Hs.421496 transforming growth factor, beta-induced, stage 68 kDa 98 HUGeneFL M82882_at 168 Hs.124030 E74-like factor 1 (ets domain transcription stage factor) 99 HUGeneFL M83822_at 168 Hs.209846 LPS-responsive vesicle trafficking, beach stage and anchor containing 100 HUGeneFL M92934_at 168 Hs.410037 connective tissue growth factor stage 101 HUGeneFL M95178_at 168 Hs.119000 actinin, alpha 1 stage 102 HUGeneFL S69115_at 168 Hs.10306 natural killer cell group 7 sequence stage 103 HUGeneFL S77393_at 168 Hs.145754 Kruppel-like factor 3 (basic) stage 104 HUGeneFL S78187_at 168 Hs.153752 cell division cycle 25B stage 105 HUGeneFL U01833_at 168 Hs.81469 nucleotide binding protein 1 (MinD stage homolog, E. coli) 106 HUGeneFL U07231_at 168 Hs.309763 G-rich RNA sequence binding factor 1 stage 107 HUGeneFL U09278_at 168 Hs.436852 fibroblast activation protein, alpha stage 108 HUGeneFL U09937_rna1_s_at 168 — — stage 109 HUGeneFL U10550_at 168 Hs.79022 GTP binding protein overexpressed in stage skeletal muscle 110 HUGeneFL U12424_s_at 168 Hs.108646 glycerol-3-phosphate dehydrogenase 2 stage (mitochondrial) 111 HUGeneFL U16306_at 168 Hs.434488 chondroitin sulfate proteoglycan 2 stage (versican) 112 HUGeneFL U20158_at 168 Hs.2488 lymphocyte cytosolic protein 2 (SH2 stage domain containing leukocyte protein of 76 kDa) 113 HUGeneFL U20536_s_at 168 Hs.3280 caspase 6, apoptosis-related cysteine stage protease 114 HUGeneFL U24266_at 168 Hs.77448 aldehyde dehydrogenase 4 family, stage member A1 115 HUGeneFL U28249_at 168 Hs.301350 FXYD domain containing ion transport stage regulator 3 116 HUGeneFL U28488_s_at 168 Hs.155935 complement component 3a receptor 1 stage 117 HUGeneFL U29680_at 168 Hs.227817 BCL2-related protein A1 stage 118 HUGeneFL U37143_at 168 Hs.152096 cytochrome P450, family 2, subfamily J, stage polypeptide 2 119 HUGeneFL U38864_at 168 Hs.108139 zinc finger protein 212 stage 120 HUGeneFL U39840_at 168 Hs.163484 forkhead box A1 stage 121 HUGeneFL U41315_rna1_s_at 168 — — stage 122 HUGeneFL U44111_at 168 Hs.42151 histamine N-methyltransferase stage 123 HUGeneFL U47414_at 168 Hs.13291 cyclin G2 stage 124 HUGeneFL U49352_at 168 Hs.414754 2,4-dienoyl CoA reductase 1, stage mitochondrial 125 HUGeneFL U50708_at 168 Hs.1265 branched chain keto acid dehydrogenase stage E1, beta polypeptide (maple syrup urine disease) 126 HUGeneFL U52101_at 168 Hs.9999 epithelial membrane protein 3 stage 127 HUGeneFL U59914_at 168 Hs.153863 MAD, mothers against decapentaplegic stage homolog 6 (Drosophila) 128 HUGeneFL U60205_at 168 Hs.393239 sterol-C4-methyl oxidase-like stage 129 HUGeneFL U61981_at 168 Hs.42674 mutS homolog 3 (E. coli) stage 130 HUGeneFL U64520_at 168 Hs.66708 vesicle-associated membrane protein 3 stage (cellubrevin) 131 HUGeneFL U65093_at 168 Hs.82071 Cbo/p300-interacting transactivator, with stage Glu/Asp-rich carboxy-terminal domain, 2 132 HUGeneFL U66619_at 168 Hs.444445 SWI/SNF related, matrix associated, actin stage dependent regulator of chromatin, subfamily d, member 3 133 HUGeneFL U68019_at 168 Hs.288261 MAD, mothers against decapentaplegic stage homolog 3 (Drosophila) 134 HUGeneFL U68385_at 168 Hs.380923 likely ortholog of mouse myeloid stage ecotropic viral integration site-related gene 2 135 HUGeneFL U68485_at 168 Hs.193163 bridging integrator 1 stage 136 HUGeneFL U74324_at 168 Hs.90875 RAB interacting factor stage 137 HUGeneFL U77970_at 168 Hs.321164 neuronal PAS domain protein 2 stage 138 HUGeneFL U83303_cds2_at 168 Hs.164021 chemokine (C—X—C motif) ligand 6 stage (granulocyte chemotactic protein 2) 139 HUGeneFL U88871_at 168 Hs.79993 peroxisomal biogenesis factor 7 stage 140 HUGeneFL U90549_at 168 Hs.236774 high mobility group nucleosomal binding stage domain 4 141 HUGeneFL U90716_at 168 Hs.79187 coxsackie virus and adenovirus receptor stage 142 HUGeneFL V00594_at 168 Hs.118786 metallothionein 2A stage 143 HUGeneFL V00594_s_at 168 Hs.118786 metallothionein 2A stage 144 HUGeneFL X02761_s_at 168 Hs.418138 fibronectin 1 stage 145 HUGeneFL X04011_at 168 Hs.88974 cytochrome b-245, beta polypeptide stage (chronic granulomatous disease) 146 HUGeneFL X04085_rna1_at 168 — — stage 147 HUGeneFL X07438_s_at 168 — — stage 148 HUGeneFL X07743_at 168 Hs.77436 pleckstrin stage 149 HUGeneFL X13334_at 168 Hs.75627 CD14 antigen stage 150 HUGeneFL X14046_at 168 Hs.153053 CD37 antigen stage 151 HUGeneFL X14813_at 168 Hs.166160 acetyl-Coenzyme A acyltransferase 1 stage (peroxisomal 3-oxoacyl-Coenzyme A thiolase) 152 HUGeneFL X15880_at 168 Hs.415997 collagen, type VI, alpha 1 stage 153 HUGeneFL X15882_at 168 Hs.420269 collagen, type VI, alpha 2 stage 154 HUGeneFL X51408_at 168 Hs.380138 chimerin (chimaerin) 1 stage 155 HUGeneFL X53800_s_at 168 Hs.89690 chemokine (C—X—C motif) ligand 3 stage 156 HUGeneFL X54489_rna1_at 168 — — stage 157 HUGeneFL X57351_s_at 168 Hs.174195 interferon induced transmembrane stage protein 2 (1-8D) 158 HUGeneFL X57579_s_at 168 — — stage 159 HUGeneFL X58072_at 168 Hs.169946 GATA binding protein 3 stage 160 HUGeneFL X62048_at 168 Hs.249441 WEE1 homolog (S. pombe) stage 161 HUGeneFL X64072_s_at 168 Hs.375957 integrin, beta 2 (antigen CD18 (p95), stage lymphocyte function-associated antigen 1; macrophage antigen 1 (mac-1) beta subunit) 162 HUGeneFL X65614_at 168 Hs.2962 S100 calcium binding protein P stage 163 HUGeneFL X66945_at 168 Hs.748 fibroblast growth factor receptor 1 (fms- stage related tyrosine kinase 2, Pfeiffer syndrome) 164 HUGeneFL X67491_f_at 168 Hs.355697 glutamate dehydrogenase 1 stage 165 HUGeneFL X68194_at 168 Hs.80919 synaptophysin-like protein stage 166 HUGeneFL X73882_at 168 Hs.254605 microtubule-associated protein 7 stage 167 HUGeneFL X78520_at 168 Hs.372528 chloride channel 3 stage 168 HUGeneFL X78549_at 168 Hs.51133 PTK6 protein tyrosine kinase 6 stage 169 HUGeneFL X78565_at 168 Hs.98998 tenascin C (hexabrachion) stage 170 HUGeneFL X78669_at 168 Hs.79088 reticulocalbin 2, EF-hand calcium binding stage domain 171 HUGeneFL X83618_at 168 Hs.59889 3-hydroxy-3-methylglutaryl-Coenzyme A stage synthase 2 (mitochondrial) 172 HUGeneFL X84908_at 168 Hs.78060 phosphorylase kinase, beta stage 173 HUGeneFL X90908_at 168 Hs.147391 fatty acid binding protein 6, ileal stage (gastrotropin) 174 HUGeneFL X91504_at 168 Hs.389277 ADP-ribosylation factor related protein 1 stage 175 HUGeneFL X95632_s_at 168 Hs.387906 abl-interactor 2 stage 176 HUGeneFL X97267_rna1_s_at 168 — — stage 177 HUGeneFL Y00705_at 168 Hs.407856 serine protease inhibitor, Kazal type 1 stage 178 HUGeneFL Y00787_s_at 168 Hs.624 interleukin 8 stage 179 HUGeneFL Y00815_at 168 Hs.75216 protein tyrosine phosphatase, receptor stage type, F 180 HUGeneFL Y08374_rna1_at 168 — — stage 181 HUGeneFL Z12173_at 168 Hs.334534 glucosamine (N-acetyl)-6-sulfatase stage (Sanfilippo disease IIID) 182 HUGeneFL Z19554_s_at 168 Hs.435800 vimentin stage 183 HUGeneFL Z26491_s_at 168 Hs.240013 catechol-O-methyltransferase stage 184 HUGeneFL Z29331_at 168 Hs.372758 ubiquitin-conjugating enzyme E2H (UBC8 stage homolog, yeast) 185 HUGeneFL Z35491_at 168 Hs.377484 BCL2-associated athanogene stage 186 HUGeneFL Z48199_at 168 Hs.82109 syndecan 1 stage 187 HUGeneFL Z48605_at 168 Hs.421825 inorganic pyrophosphatase 2 stage 188 HUGeneFL Z74615_at 168 Hs.172928 collagen, type I, alpha 1 stage 189 HUGeneFL D87437_at 168 Hs.43660 chromosome 1 open reading frame 16 recurrence 190 HUGeneFL L49169_at 168 Hs.75678 FBJ murine osteosarcoma viral oncogene recurrence homolog B 191 HUGeneFL AF006041_at 168 Hs.336916 death-associated protein 6 recurrence 192 HUGeneFL D83780_at 168 Hs.437991 KIAA0196 gene product recurrence 193 HUGeneFL D64154_at 168 Hs.90107 adhesion regulating molecule 1 recurrence 194 HUGeneFL D21337_at 168 Hs.408 collagen, type IV, alpha 6 recurrence 195 HUGeneFL M16938_s_at 168 Hs.820 homeo box C6 recurrence 196 HUGeneFL D87258_at 168 Hs.75111 protease, serine, 11 (IGF binding) recurrence 197 HUGeneFL U58516_at 168 Hs.3745 milk fat globule-EGF factor 8 protein recurrence 198 HUGeneFL U45973_at 168 Hs.178347 skeletal muscle and kidney enriched recurrence inositol phosphatase 199 HUGeneFL U62015_at 168 Hs.8867 cysteine-rich, angiogenic inducer, 61 recurrence 200 HUGeneFL U94855_at 168 Hs.381255 eukaryotic translation initiation factor 3, recurrence subunit 5 epsilon, 47 kDa 201 HUGeneFL L34155_at 168 Hs.83450 laminin, alpha 3 recurrence 202 HUGeneFL U70439_s_at 168 Hs.84264 acidic (leucine-rich) nuclear recurrence phosphoprotein 32 family, member B 203 HUGeneFL U66702_at 168 Hs.74624 protein tyrosine phosphatase, receptor recurrence type, N polypeptide 2 204 HUGeneFL HG511-HT511_at 168 — — recurrence 205 HUGeneFL HG3076- 168 — — recurrence HT3238_s_at 206 HUGeneFL M98528_at 168 Hs.79404 DNA segment on chromosome 4 (unique) recurrence 234 expressed sequence 207 HUGeneFL M63175_at 168 Hs.295137 autocrine motility factor receptor recurrence 208 HUGeneFL D49387_at 168 Hs.294584 leukotriene B4 12-hydroxydehydrogenase recurrence 209 HUGeneFL HG1879- 168 — — recurrence HT1919_at 210 HUGeneFL Z23064_at 168 Hs.380118 RNA binding motif protein, X chromosome recurrence 211 HUGeneFL X63469_at 168 Hs.77100 general transcription factor IIE, recurrence polypeptide 2, beta 34 kDa 212 HUGeneFL L38928_at 168 Hs.118131 5,10-methenyltetrahydrofolate recurrence synthetase (5-formyltetrahydrofolate cyclo-ligase) 213 HUGeneFL U21858_at 168 Hs.60679 TAF9 RNA polymerase II, TATA box binding recurrence protein (TBP)-associated factor, 32 kDa 214 HUGeneFL M64572_at 168 Hs.405666 protein tyrosine phosphatase, non- recurrence receptor type 3 215 HUGeneFL D83657_at 168 Hs.19413 S100 calcium binding protein A12 SCC (calgranulin C) 216 HUGeneFL HG3945- 168 — — SCC HT4215_at 217 HUGeneFL J00124_at 168 — — SCC 218 HUGeneFL L05187_at 168 — — SCC 219 HUGeneFL L42583_f_at 168 Hs.367762 keratin 6A SCC 220 HUGeneFL L42601_f_at 168 Hs.367762 keratin 6A SCC 221 HUGeneFL L42611_f_at 168 Hs.446417 keratin 6E SCC 222 HUGeneFL M19888_at 168 Hs.1076 small proline-rich protein 1B (cornifin) SCC 223 HUGeneFL M20030_f_at 168 Hs.505352 Human small proline rich protein (sprII) SCC mRNA, clone 930. 224 HUGeneFL M21005_at 168 — — SCC 225 HUGeneFL M21302_at 168 Hs.505327 Human small proline rich protein (sprII) SCC mRNA, clone 174N. 226 HUGeneFL M21539_at 168 Hs.2421 small proline-rich protein 2C SCC 227 HUGeneFL M86757_s_at 168 Hs.112408 S100 calcium binding protein A7 (psoriasin SCC 1) 228 HUGeneFL S72493_s_at 168 Hs.432448 keratin 16 (focal non-epidermolytic SCC palmoplantar keratoderma) 229 HUGeneFL U70981_at 168 Hs.336046 interleukin 13 receptor, alpha 2 SCC 230 HUGeneFL V01516_f_at 168 Hs.367762 keratin 6A SCC 231 HUGeneFL X53065_f_at 168 — — SCC 232 HUGeneFL X57766_at 168 Hs.143751 matrix metalloproteinase 11 (stromelysin SCC 3) 233 EOS Hu03 400773 133 — NM_003105*: Homo sapiens sortilin- progression related receptor, L(DLR class) A repeats- containing (SORL1), mRNA. 234 EOS Hu03 400843 133 — NM_003105*: Homo sapiens sortilin- progression related receptor, L(DLR class) A repeats- containing (SORL1), mRNA. 235 EOS Hu03 400844 133 — NM_003105*: Homo sapiens sortilin- progression related receptor, L(DLR class) A repeats- containing (SORL1), mRNA. 236 EOS Hu03 400846 133 — sortilin-related receptor, L(DLR class) A progression repeats-containing (SORL1) 237 EOS Hu03 402328 133 — Target Exon progression 238 EOS Hu03 402384 133 — NM_007181*: Homo sapiens mitogen- progression activated protein kinase kinase kinase kinase 1 (MAP4K1), mRNA. 239 EOS Hu03 404208 133 — C6001282: gi|4504223|ref|NP_000172.1| progression glucuronidase, beta [Homo sapiens] gi|114963|sp|P082 240 EOS Hu03 404606 133 — Target Exon progression 241 EOS Hu03 404826 133 — Target Exon progression 242 EOS Hu03 404875 133 — NM_022819*: Homo sapiens progression phospholipase A2, group IIF (PLA2G2F), mRNA. VERSION NM_020245.2 GI 243 EOS Hu03 404913 133 — NM_024408*: Homo sapiens Notch progression (Drosophila) homolog 2 (NOTCH2), mRNA. VERSION NM_024410.1 GI 244 EOS Hu03 404977 133 — Insulin-like growth factor 2 (somatomedin progression A) (IGF2) 245 EOS Hu03 405036 133 — NM_021628*: Homo sapiens arachidonate progression lipoxygenase 3 (ALOXE3), mRNA. VERSION NM_020229.1 GI 246 EOS Hu03 405371 133 — NM_005569*: Homo sapiens LIM domain progression kinase 2 (LIMK2), transcript variant 2a, mRNA. 247 EOS Hu03 405667 133 — Target Exon progression 248 EOS Hu03 406002 133 — Target Exon progression 249 EOS Hu03 407955 133 Hs.9343 ESTs progression 250 EOS Hu03 408049 133 Hs.345588 desmoplakin (DPI, DPII) progression 251 EOS Hu03 408288 133 Hs.16886 gb: zI73d06.r1 Stratagene colon (937204) progression Homo sapiens cDNA clone 5′, mRNA sequence 252 EOS Hu03 409513 133 Hs.54642 methionine adenosyltransferase II, beta progression 253 EOS Hu03 409556 133 Hs.54941 phosphorylase kinase, alpha 2 (liver) progression 254 EOS Hu03 409586 133 Hs.55044 DKFZP586H2123 protein progression 255 EOS Hu03 409632 133 Hs.55279 serine (or cysteine) proteinase inhibitor, progression clade B (ovalbumin), member 5 256 EOS Hu03 410047 133 Hs.379753 zinc finger protein 36 (KOX 18) progression 257 EOS Hu03 411817 133 Hs.72241 mitogen-activated protein kinase kinase 2 progression 258 EOS Hu03 412649 133 Hs.74369 integrin, alpha 7 progression 259 EOS Hu03 412841 133 Hs.101395 hypothetical protein MGC11352 progression 260 EOS Hu03 413564 133 — gb: 601146990F1 NIH_MGC_19 Homo progression sapiens cDNA clone 5′, mRNA sequence 261 EOS Hu03 413786 133 Hs.13500 ESTs progression 262 EOS Hu03 413840 133 Hs.356228 RNA binding motif protein, X chromosome progression 263 EOS Hu03 413929 133 Hs.75617 collagen, type IV, alpha 2 progression 264 EOS Hu03 414223 133 Hs.238246 hypothetical protein FLJ22479 progression 265 EOS Hu03 414732 133 Hs.77152 minichromosome maintenance deficient progression (S. cerevisiae) 7 266 EOS Hu03 414762 133 Hs.77257 KIAA0068 protein progression 267 EOS Hu03 414840 133 Hs.23823 hairy/enhancer-of-split related with YRPW progression motif-like 268 EOS Hu03 414843 133 Hs.77492 heterogeneous nuclear ribonucleoprotein progression A0 269 EOS Hu03 414895 133 Hs.116278 Homo sapiens cDNA FLJ13571 fis, clone progression PLACE1008405 270 EOS Hu03 414907 133 Hs.77597 polo (Drosophia)-like kinase progression 271 EOS Hu03 414918 133 Hs.72222 hypothetical protein FLJ13459 progression 272 EOS Hu03 415200 133 Hs.78202 SWI/SNF related, matrix associated, actin Progression dependent regulator of chromatin, subfamily a, member 4 273 EOS Hu03 416640 133 Hs.79404 neuron-specific protein Progression 274 EOS Hu03 416815 133 Hs.80120 UDP-N-acetyl-alpha-D- Progression galactosamine:polypeptide N- acetylgalactosaminyltransferase 1 (GalNAc-T1) 275 EOS Hu03 416977 133 Hs.406103 hypothetical protein FKSG44 Progression 276 EOS Hu03 417615 133 Hs.82314 hypoxanthine phosphoribosyltransferase Progression 1 (Lesch-Nyhan syndrome) 277 EOS Hu03 417839 133 Hs.82712 fragile X mental retardation, autosomal Progression homolog 1 278 EOS Hu03 417900 133 Hs.82906 CDC20 (cell division cycle 20, S. cerevisiae, Progression homolog) 279 EOS Hu03 417924 133 Hs.82932 cyclin D1 (PRAD1: parathyroid Progression adenomatosis 1) 280 EOS Hu03 418127 133 Hs.83532 membrane cofactor protein (CD46, Progression trophoblast-lymphocyte cross-reactive antigen) 281 EOS Hu03 418321 133 Hs.84087 KIAA0143 protein Progression 282 EOS Hu03 418504 133 Hs.85335 Homo sapiens mRNA; cDNA Progression DKFZp564D1462 (from clone DKFZp564D1462) 283 EOS Hu03 418629 133 Hs.86859 growth factor receptor-bound protein 7 Progression 284 EOS Hu03 419602 133 Hs.91521 hypothetical protein Progression 285 EOS Hu03 419847 133 Hs.184544 Homo sapiens, clone IMAGE: 3355383, Progression mRNA, partial cds 286 EOS Hu03 420079 133 Hs.94896 PTD011 protein Progression 287 EOS Hu03 420116 133 Hs.95231 FH1/FH2 domain-containing protein Progression 288 EOS Hu03 420307 133 Hs.66219 ESTs Progression 289 EOS Hu03 420613 133 Hs.406637 ESTs, Weakly similar to A47582 B-cell Progression growth factor precursor [H. sapiens] 290 EOS Hu03 420732 133 Hs.367762 ESTs Progression 291 EOS Hu03 421026 133 Hs.101067 GCNS (general control of amino-acid Progression synthesis, yeast, homolog)-like 2 292 EOS Hu03 421075 133 Hs.101474 KIAA0807 protein Progression 293 EOS Hu03 421101 133 Hs.101840 major histocompatibility complex, class I- Progression like sequence 294 EOS Hu03 421186 133 Hs.270563 ESTs, Moderately similar to T12512 Progression hypothetical protein DKFZp434G232.1 [H. sapiens] 295 EOS Hu03 421311 133 Hs.283609 hypothetical protein PRO2032 progression 296 EOS Hu03 421475 133 Hs.104640 HIV-1 inducer of short transcripts binding progression protein; lymphoma related factor 297 EOS Hu03 421505 133 Hs.285641 KIAA1111 protein progression 298 EOS Hu03 421595 133 Hs.301685 KIAA0620 protein progression 299 EOS Hu03 421628 133 Hs.106210 hypothetical protein FLJ10813 progression 300 EOS Hu03 421649 133 Hs.106415 peroxisome proliferative activated progression receptor, delta 301 EOS Hu03 421733 133 Hs.1420 fibroblast growth factor receptor 3 progression (achondroplasia, thanatophoric dwarfism) 302 EOS Hu03 421782 133 Hs.108258 actin binding protein; macrophin progression (microfilament and actin filament cross- linker protein) 303 EOS Hu03 421989 133 Hs.110457 Wolf-Hirschhorn syndrome candidate 1 progression 304 EOS Hu03 422043 133 Hs.110953 retinoic acid induced 1 progression 305 EOS Hu03 422068 133 Hs.104520 Homo sapiens cDNA FLJ13694 fis, clone progression PLACE2000115 306 EOS Hu03 422506 133 Hs.300741 sorcin progression 307 EOS Hu03 422913 133 Hs.121599 CGI-18 protein progression 308 EOS Hu03 422929 133 Hs.94011 ESTs, Weakly similar to MGB4_HUMAN progression MELANOMA-ASSOCIATED ANTIGEN B4 [H. sapiens] 309 EOS Hu03 422959 133 Hs.349256 paired immunoglobulin-like receptor beta progression 310 EOS Hu03 423138 133 — gb: EST385571 MAGE resequences, MAGM progression Homo sapiens cDNA, mRNA sequence 311 EOS Hu03 423185 133 Hs.380062 ornithine decarboxylase antizyme 1 progression 312 EOS Hu03 423599 133 Hs.31731 peroxiredoxin 5 progression 313 EOS Hu03 423810 133 Hs.132955 BCL2/adenovirus E1B 19 kD-interacting progression protein 3-like 314 EOS Hu03 423960 133 Hs.136309 SH3-containing protein SH3GLB1 progression 315 EOS Hu03 424244 133 Hs.143601 hypothetical protein hCLA-iso progression 316 EOS Hu03 424415 133 Hs.146580 enolase 2, (gamma, neuronal) progression 317 EOS Hu03 424909 133 Hs.153752 cell division cycle 25B progression 318 EOS Hu03 424959 133 Hs.153937 activated p21cdc42Hs kinase progression 319 EOS Hu03 425093 133 Hs.154525 KIAA1076 protein progression 320 EOS Hu03 425097 133 Hs.154545 PDZ domain containing guanine progression nucleotide exchange factor(GEF)1 321 EOS Hu03 425205 133 Hs.155106 receptor (calcitonin) activity modifying progression protein 2 322 EOS Hu03 425221 133 Hs.155188 TATA box binding protein (TBP)-associated progression factor, RNA polymerase II, F, 55 kD 323 EOS Hu03 425243 133 Hs.155291 KIAA0005 gene product progression 324 EOS Hu03 425380 133 Hs.32148 AD-015 protein progression 325 EOS Hu03 426028 133 Hs.172028 a disintegrin and metalloproteinase progression domain 10 (ADAM10) 326 EOS Hu03 426125 133 Hs.166994 FAT tumor suppressor (Drosophila) progression homolog 327 EOS Hu03 426177 133 Hs.167700 Homo sapiens cDNA FLJ10174 fis, clone progression HEMBA1003959 328 EOS Hu03 426252 133 Hs.28917 ESTs progression 329 EOS Hu03 426468 133 Hs.117558 ESTs progression 330 EOS Hu03 426469 133 Hs.363039 methylmalonate-semialdehyde progression dehydrogenase 331 EOS Hu03 426508 133 Hs.170171 glutamate-ammonia ligase (glutamine progression synthase) 332 EOS Hu03 426682 133 Hs.2056 UDP glycosyltransferase 1 family, progression polypeptide A9 333 EOS Hu03 426799 133 Hs.303154 popeye protein 3 progression 334 EOS Hu03 426982 133 Hs.173091 ubiquitin-like 3 progression 335 EOS Hu03 427239 133 Hs.356512 ubiquitin carrier protein progression 336 EOS Hu03 427351 133 Hs.123253 hypothetical protein FLJ22009 progression 337 EOS Hu03 427681 133 Hs.284232 tumor necrosis factor receptor progression superfamily, member 12 (translocating chain-association membrane protein) 338 EOS Hu03 427722 133 Hs.180479 hypothetical protein FLJ20116 progression 339 EOS Hu03 427747 133 Hs.180655 serine/threonine kinase 12 progression 340 EOS Hu03 427999 133 Hs.181369 ubiquitin fusion degradation 1-like progression 341 EOS Hu03 428115 133 Hs.300855 KIAA0977 protein progression 342 EOS Hu03 428284 133 Hs.183435 NM_004545: Homo sapiens NADH progression dehydrogenase (ubiquinone) 1 beta subcomplex, 1 (7 kD, MNLL) (NDUFB1), mRNA. 343 EOS Hu03 428318 133 Hs.356190 ubiquitin B progression 344 EOS Hu03 428712 133 Hs.190452 KIAA0365 gene product progression 345 EOS Hu03 428901 133 Hs.146668 KIAA1253 protein progression 346 EOS Hu03 429124 133 Hs.196914 minor histocompatibility antigen HA-1 progression 347 EOS Hu03 429187 133 Hs.163872 ESTs, Weakly similar to S65657 alpha-1C- progression adrenergic receptor splice form 2 [H. sapiens] 348 EOS Hu03 429311 133 Hs.198998 conserved helix-loop-helix ubiquitous progression kinase 349 EOS Hu03 429561 133 Hs.250646 baculoviral IAP repeat-containing 6 progression 350 EOS Hu03 429802 133 Hs.5367 ESTs, Weakly similar to I38022 progression hypothetical protein [H. sapiens] 351 EOS Hu03 429953 133 Hs.226581 COX15 (yeast) homolog, cytochrome c progression oxidase assembly protein 352 EOS Hu03 430604 133 Hs.247309 succinate-CoA ligase, GDP-forming, beta progression subunit 353 EOS Hu03 430677 133 Hs.359784 desmoglein 2 progression 354 EOS Hu03 430746 133 Hs.406256 ESTs progression 355 EOS Hu03 431604 133 Hs.264190 vacuolar protein sorting 35 (yeast progression homolog) 356 EOS Hu03 431842 133 Hs.271473 epithelial protein up-regulated in progression carcinoma, membrane associated protein 17 357 EOS Hu03 431857 133 Hs.271742 ADP-ribosyltransferase (NAD; poly (ADP- progression ribose) polymerase)-like 3 358 EOS Hu03 432258 133 Hs.293039 ESTs progression 359 EOS Hu03 432327 133 Hs.274363 neuroglobin progression 360 EOS Hu03 432554 133 Hs.278411 NCK-associated protein 1 progression 361 EOS Hu03 432864 133 Hs.359682 calpastatin progression 362 EOS Hu03 433052 133 Hs.293003 ESTs, Weakly similar to PC4259 ferritin progression associated protein [H. sapiens] 363 EOS Hu03 433282 133 Hs.49007 hypothetical protein progression 364 EOS Hu03 433844 133 Hs.179647 Homo sapiens cDNA FLJ12195 fis, clone progression MAMMA1000865 365 EOS Hu03 433914 133 Hs.112160 Homo sapiens DNA helicase homolog progression (PIF1) mRNA, partial cds 366 EOS Hu03 434055 133 Hs.3726 x 003 protein progression 367 EOS Hu03 434263 133 Hs.79187 ESTs progression 368 EOS Hu03 434547 133 Hs.106124 ESTs progression 369 EOS Hu03 434831 133 Hs.273397 KIAA0710 gene product progression 370 EOS Hu03 434978 133 Hs.4310 eukaryotic translation initiation factor 1A progression 371 EOS Hu03 435158 133 Hs.65588 DAZ associated protein 1 progression 372 EOS Hu03 435320 133 Hs.117864 ESTs progression 373 EOS Hu03 435521 133 Hs.6361 mitogen-activated protein kinase kinase 1 progression interacting protein 1 374 EOS Hu03 436472 133 Hs.46366 KIAA0948 protein progression 375 EOS Hu03 436576 133 Hs.77542 ESTs progression 376 EOS Hu03 437223 133 Hs.330716 Homo sapiens cDNA FLJ14368 fis, clone progression HEMBA1001122 377 EOS Hu03 437256 133 Hs.97871 Homo sapiens, clone IMAGE: 3845253, progression mRNA, partial cds 378 EOS Hu03 437524 133 Hs.385719 ESTs progression 379 EOS Hu03 438013 133 Hs.15670 ESTs progression 380 EOS Hu03 438644 133 Hs.129037 ESTs progression 381 EOS Hu03 438818 133 Hs.30738 ESTs progression 382 EOS Hu03 438942 133 Hs.6451 PRO0659 protein progression 383 EOS Hu03 439010 133 Hs.75216 Homo sapiens cDNA FLJ13713 fis, clone progression PLACE2000398, moderately similar to LAR PROTEIN PRECURSOR (LEUKOCYTE ANTIGEN RELATED) (EC 3.1.3.48) 384 EOS Hu03 439130 133 Hs.375195 ESTs progression 385 EOS Hu03 439578 133 Hs.350547 nuclear receptor co-repressor/HDAC3 progression complex subunit 386 EOS Hu03 439632 133 Hs.334437 hypothetical protein MGC4248 progression 387 EOS Hu03 440014 133 Hs.6856 ash2 (absent, small, or homeotic, progression Drosophila, homolog)-like 388 EOS Hu03 440100 133 Hs.158549 ESTs, Weakly similar to T2D3_HUMAN progression TRANSCRIPTION INITIATION FACTOR TFIID 135 KDA SUBUNIT [H. sapiens] 389 EOS Hu03 440197 133 Hs.317714 pallid (mouse) homolog, pallidin progression 390 EOS Hu03 440357 133 Hs.20950 phospholysine phosphohistidine inorganic progression pyrophosphate phosphatase 391 EOS Hu03 441650 133 Hs.132545 ESTs progression 392 EOS Hu03 442220 133 Hs.8148 selenoprotein T progression 393 EOS Hu03 442549 133 Hs.8375 TNF receptor-associated factor 4 progression 394 EOS Hu03 443407 133 Hs.348514 ESTs, Moderately similar to 2109260A B progression cell growth factor [H. sapiens] 395 EOS Hu03 443471 133 Hs.398102 Homo sapiens clone FLB3442 PRO0872 progression mRNA, complete cds 396 EOS Hu03 443679 133 Hs.9670 hypothetical protein FLJ10948 progression 397 EOS Hu03 443893 133 Hs.115472 ESTs, Weakly similar to 2004399A progression chromosomal protein [H. sapiens] 398 EOS Hu03 444037 133 Hs.380932 CHMP1.5 protein progression 399 EOS Hu03 444312 133 Hs.351142 ESTs progression 400 EOS Hu03 444336 133 Hs.10882 HMG-box containing protein 1 progression 401 EOS Hu03 444604 133 Hs.11441 chromosome 1 open reading frame 8 progression 402 EOS Hu03 445084 133 Hs.250848 hypothetical protein FLJ14761 progression 403 EOS Hu03 445462 133 Hs.288649 hypothetical protein MGC3077 progression 404 EOS Hu03 445692 133 Hs.182099 ESTs progression 405 EOS Hu03 445831 133 Hs.13351 LanC (bacterial lantibiotic synthetase progression component C)-like 1 406 EOS Hu03 446556 133 Hs.15303 KIAA0349 protein progression 407 EOS Hu03 446847 133 Hs.82845 Homo sapiens cDNA: FLJ21930 fis, clone progression HEP04301, highly similar to HSU90916 Human clone 23815 mRNA sequence 408 EOS Hu03 447343 133 Hs.236894 ESTs, Highly similar to S02392 alpha-2- progression macroglobulin receptor precursor [H. sapiens] 409 EOS Hu03 447400 133 Hs.18457 hypothetical protein FLJ20315 progression 410 EOS Hu03 448357 133 Hs.108923 RAB38, member RAS oncogene family progression 411 EOS Hu03 448524 133 Hs.21356 hypothetical protein DKFZp762K2015 progression 412 EOS Hu03 448625 133 Hs.178470 hypothetical protein FLJ22662 progression 413 EOS Hu03 448780 133 Hs.267749 Human DNA sequence from clone 366N23 progression on chromosome 6q27. Contains two genes similar to consecutive parts of the C. elegans UNC-93 (protein 1, C46F11.1) gene, a KIAA0173 and Tubulin-Tyrosine Ligase LIKE gene, a Mitotic Feedback Control Protein MADP2 H 414 EOS Hu03 448813 133 Hs.22142 cytochrome b5 reductase b5R.2 progression 415 EOS Hu03 449268 133 Hs.23412 hypothetical protein FLJ20160 progression 416 EOS Hu03 449626 133 Hs.112860 zinc finger protein 258 progression 417 EOS Hu03 450893 133 Hs.25625 hypothetical protein FLJ11323 progression 418 EOS Hu03 450997 133 Hs.35254 hypothetical protein FLB6421 progression 419 EOS Hu03 451164 133 Hs.60659 ESTs, Weakly similar to T46471 progression hypothetical protein DKFZp434L0130.1 [H. sapiens] 420 EOS Hu03 451225 133 Hs.57655 ESTs progression 421 EOS Hu03 451867 133 Hs.27192 hypothetical protein dJ1057B20.2 progression 422 EOS Hu03 451970 133 Hs.211046 ESTs progression 423 EOS Hu03 452012 133 Hs.279766 kinesin family member 4A progression 424 EOS Hu03 452170 133 Hs.28285 patched related protein translocated in progression renal cancer 425 EOS Hu03 452517 133 — gb: RC-BT068-130399-068 BT068 Homo progression sapiens cDNA, mRNA sequence 426 EOS Hu03 452829 133 Hs.63368 ESTs, Weakly similar to TRHY_HUMAN progression TRICHOHYALI [H. sapiens] 427 EOS Hu03 452929 133 Hs.172816 neuregulin 1 progression 428 EOS Hu03 453395 133 Hs.377915 mannosidase, alpha, class 2A, member 1 progression 429 EOS Hu03 454639 133 — gb: RC2-ST0158-091099-011-d05 ST0158 progression Homo sapiens cDNA, mRNA sequence 430 EOS Hu03 456332 133 Hs.399939 gb: nc39d05.r1 NCI_CGAP_Pr2 Homo progression sapiens cDNA clone, mRNA sequence 431 EOS Hu03 457228 133 Hs.195471 Human cosmid CRI-JC2015 at D10S289 in progression 10sp13 432 EOS Hu03 458132 133 Hs.103267 hypothetical protein FLJ22548 similar to progression gene trap PAT 12 433 EOS Hu03 408688 133 Hs.152925 KIAA1268 protein progression 434 EOS Hu03 410691 133 Hs.65450 reticulon 4 progression 435 EOS Hu03 420269 133 Hs.96264 alpha thalassemia/mental retardation progression syndrome X-linked (RAD54 (S. cerevisiae) homolog) 436 EOS Hu03 422119 133 Hs.111862 KIAA0590 gene product progression 437 EOS Hu03 422765 133 Hs.1578 baculoviral IAP repeat-containing 5 progression (survivin) 438 EOS Hu03 422984 133 Hs.351597 ESTs progression 439 EOS Hu03 428016 133 Hs.181461 ariadne homolog, ubiquitin-conjugating progression enzyme E2 binding protein, 1 (Drosophila) 440 EOS Hu03 437325 133 Hs.5548 F-box and leucine-rich repeat protein 5 progression 441 EOS Hu03 444773 133 Hs.11923 hypothetical protein DJ167A19.1 progression 442 EOS Hu03 445926 133 Hs.334826 splicing factor 3b, subunit 1, 155 kDa progression 443 EOS Hu03 452714 133 Hs.30340 KIAA1165: likely ortholog of mouse Nedd4 progression WW domain-binding protein 5A 444 EOS Hu03 452866 133 Hs.268016 ESTs progression 445 EOS Hu03 453963 133 Hs.28959 cDNA FLJ36513 fis, clone TRACH2001523 progression 446 EOS Hu03 457329 133 Hs.359682 calpastatin progression 447 U133A 200600_at 168 Hs.170328 NM_001910; cathepsin E isoform a CIS preproprotein NM_148964; cathepsin E isoform b preproprotein 448 U133A 200762_at 168 Hs.173381 NM_019894; transmembrane protease, CIS serine 4 isoform 1 NM_183247; transmembrane protease, serine 4 isoform 2 449 U133A 201088_at 168 Hs.159557 NM_000228; laminin subunit beta 3 CIS precursor 450 U133A 201291_s_at 168 Hs.156346 NM_030570; uroplakin 3B isoform a CIS NM_182683; uroplakin 3B isoform c NM_182684; uroplakin 3B isoform b 451 U133A 201560_at 168 Hs.25035 NM_005547; involucrin CIS 452 U133A 201616_s_at 168 Hs.443811 NM_004692; NM_032727; internexin CIS neuronal intermediate filament protein, alpha 453 U133A 201641_at 168 Hs.118110 NM_016233; peptidylarginine deiminase CIS type III 454 U133A 201744_s_at 168 Hs.406475 NM_014417; BCL2 binding component 3 CIS 455 U133A 201842_s_at 168 Hs.76224 NM_020142; NADH:ubiquinone CIS oxidoreductase MLRQ subunit homolog 456 U133A 201858_s_at 168 Hs.1908 NM_018058; cartilage acidic protein 1 CIS 457 U133A 201859_at 168 Hs.1908 NM_000497; cytochrome P450, subfamily CIS XIB (steroid 11-beta-hydroxylase), polypeptide 1 precursor 458 U133A 202746_at 168 Hs.17109 NM_007193; annexin A10 CIS 459 U133A 202917_s_at 168 Hs.416073 NM_001958; eukaryotic translation CIS elongation factor 1 alpha 2 460 U133A 203009_at 168 Hs.155048 NM_005581; Lutheran blood group CIS (Auberger b antigen included) 461 U133A 203287_at 168 Hs.18141 NM_005581; Lutheran blood group CIS (Auberger b antigen included) 462 U133A 203477_at 168 Hs.409034 NM_030570; uroplakin 3B isoform a CIS NM_182683; uroplakin 3B isoform c NM_182684; uroplakin 3B isoform b 463 U133A 203649_s_at 168 Hs.76422 NM_000300; phospholipase A2, group IIA CIS (platelets, synovial fluid) 464 U133A 203759_at 168 Hs.75268 NM_007193; annexin A10 CIS 465 U133A 203792_x_at 168 Hs.371617 NM_007144; ring finger protein 110 CIS 466 U133A 203842_s_at 168 Hs.172740 NM_014417; BCL2 binding component 3 CIS 467 U133A 203980_at 168 Hs.391561 NM_001442; fatty acid binding protein 4, CIS adipocyte 468 U133A 204141_at 168 Hs.300701 NM_017689; hypothetical protein CIS FLJ20151 469 U133A 204380_s_at 168 Hs.1420 NM_007144; ring finger protein 110 CIS 470 U133A 204465_s_at 168 Hs.76888 NM_004692; NM_032727; internexin CIS neuronal intermediate filament protein, alpha 471 U133A 204487_s_at 168 Hs.367809 NM_001248; ectonucleoside triphosphate CIS diphosphohydrolase 3 472 U133A 204508_s_at 168 Hs.279916 NM_017689; hypothetical protein CIS FLJ20151 473 U133A 204540_at 168 Hs.433839 NM_001958; eukaryotic translation CIS elongation factor 1 alpha 2 474 U133A 204688_at 168 Hs.409798 NM_016233; peptidylarginine deiminase CIS type III 475 U133A 204952_at 168 Hs.377028 NM_000445; plectin 1, intermediate CIS filament binding protein 500 kDa 476 U133A 204990_s_at 168 Hs.85266 NM_000213; integrin, beta 4 CIS 477 U133A 205073_at 168 Hs.152096 NM_019894; transmembrane protease, CIS serine 4 isoform 1 NM_183247; transmembrane protease, serine 4 isoform 2 478 U133A 205382_s_at 168 Hs.155597 NM_000213; integrin, beta 4 CIS 479 U133A 205453_at 168 Hs.290432 NM_002145; homeo box B2 CIS 480 U133A 205455_at 168 Hs.2942 NM_006760; uroplakin 2 CIS 481 U133A 205927_s_at 168 Hs.1355 NM_001910; cathepsin E isoform a CIS preproprotein NM_148964; cathepsin E isoform b preproprotein 482 U133A 206122_at 168 Hs.95582 NM_006942; SRY-box 15 CIS 483 U133A 206191_at 168 Hs.47042 NM_001248; ectonucleoside triphosphate CIS diphosphohydrolase 3 484 U133A 206392_s_at 168 Hs.82547 NM_005522; homeobox A1 protein CIS isoform a NM_153620; homeobox A1 protein isoform b 485 U133A 206393_at 168 Hs.83760 NM_003282; troponin I, skeletal, fast CIS 486 U133A 206465_at 168 Hs.277543 NM_015162; lipidosin CIS 487 U133A 206561_s_at 168 Hs.116724 NM_015162; lipidosin CIS 488 U133A 206658_at 168 Hs.284211 NM_030570; uroplakin 3B isoform a CIS NM_182683; uroplakin 3B isoform c NM_182684; uroplakin 3B isoform b 489 U133A 207173_x_at 168 Hs.443435 NM_000213; integrin, beta 4 CIS 490 U133A 207862_at 168 Hs.379613 NM_006760; uroplakin 2 CIS 491 U133A 209138_x_at 168 Hs.505407 NM_015162; lipidosin CIS 492 U133A 209270_at 168 Hs.436983 NM_000228; laminin subunit beta 3 CIS precursor 493 U133A 209340_at 168 Hs.21293 NM_007144; ring finger protein 110 CIS 494 U133A 209591_s_at 168 Hs.170195 NM_000228; laminin subunit beta 3 CIS precursor 495 U133A 209732_at 168 Hs.85201 NM_001248; ectonucleoside triphosphate CIS diphosphohydrolase 3 496 U133A 210143_at 168 Hs.188401 NM_007193; annexin A10 CIS 497 U133A 210735_s_at 168 Hs.5338 NM_017689; hypothetical protein CIS FLJ20151 498 U133A 210761_s_at 168 Hs.86859 NM_020142; NADH:ubiquinone CIS oxidoreductase MLRQ subunit homolog 499 U133A 211002_s_at 168 Hs.82237 NM_001958; eukaryotic translation CIS elongation factor 1 alpha 2 500 U133A 211161_s_at 168 NM_000300; phospholipase A2, group IIA CIS (platelets, synovial fluid) 501 U133A 211430_s_at 168 Hs.413826 NM_001910; cathepsin E isoform a CIS preproprotein NM_148964; cathepsin E isoform b preproprotein 502 U133A 211671_s_at 168 Hs.126608 NM_007144; ring finger protein 110 CIS 503 U133A 211692_s_at 168 Hs.87246 NM_014417; BCL2 binding component 3 CIS 504 U133A 211896_s_at 168 Hs.156316 NM_005581; Lutheran blood group CIS (Auberger b antigen included) 505 U133A 212077_at 168 Hs.443811 NM_003282; troponin I, skeletal, fast CIS 506 U133A 212192_at 168 Hs.109438 NM_020142; NADH:ubiquinone CIS oxidoreductase MLRQ subunit homolog 507 U133A 212195_at 168 Hs.71968 NM_000445; plectin 1, intermediate CIS filament binding protein 500 kDa 508 U133A 212386_at 168 Hs.359289 NM_005547; involucrin CIS 509 U133A 212667_at 168 Hs.111779 NM_000299; plakophilin 1 CIS 510 U133A 212671_s_at 168 Hs.387679 NM_002145; homeo box B2 CIS 511 U133A 212998_x_at 168 Hs.375115 NM_000497; cytochrome P450, subfamily CIS XIB (steroid 11-beta-hydroxylase), polypeptide 1 precursor 512 U133A 213891_s_at 168 Hs.359289 NM_007193; annexin A10 CIS 513 U133A 213975_s_at 168 Hs.234734 NM_005522; homeobox A1 protein CIS isoform a NM_153620; homeobox A1 protein isoform b 514 U133A 214352_s_at 168 Hs.412107 NM_006760; uroplakin 2 CIS 515 U133A 214599_at 168 Hs.157091 NM_005547; involucrin CIS 516 U133A 214630_at 168 Hs.184927 NM_000497; cytochrome P450, subfamily CIS XIB (steroid 11-beta-hydroxylase), polypeptide 1 precursor 517 U133A 214639_s_at 168 Hs.67397 NM_005522; homeobox A1 protein CIS isoform a NM_153620; homeobox A1 protein isoform b 518 U133A 214651_s_at 168 Hs.127428 NM_002145; homeo box B2 CIS 519 U133A 214669_x_at 168 Hs.377975 NM_001442; fatty acid binding protein 4, CIS adipocyte 520 U133A 214677_x_at 168 Hs.449601 NM_006942; SRY-box 15 CIS 521 U133A 214752_x_at 168 Hs.195464 NM_006942; SRY-box 15 CIS 522 U133A 215076_s_at 168 Hs.443625 NM_016233; peptidylarginine deiminase CIS type III 523 U133A 215121_x_at 168 Hs.356861 NM_018058; cartilage acidic protein 1 CIS 524 U133A 215176_x_at 168 Hs.503443 NM_001248; ectonucleoside triphosphate CIS diphosphohydrolase 3 525 U133A 215379_x_at 168 Hs.449601 NM_006760; uroplakin 2 CIS 526 U133A 215812_s_at 168 Hs.499113 NM_018058; cartilage acidic protein 1 CIS 527 U133A 216641_s_at 168 Hs.18141 NM_005547; involucrin CIS 528 U133A 216971_s_at 168 Hs.79706 NM_000445; plectin 1, intermediate CIS filament binding protein 500 kDa 529 U133A 217028_at 168 Hs.421986 NM_003282; troponin I, skeletal, fast CIS 530 U133A 217040_x_at 168 Hs.95582 NM_001910; cathepsin E isoform a CIS preproprotein NM_148964; cathepsin E isoform b preproprotein 531 U133A 217388_s_at 168 Hs.444471 NM_000228; laminin subunit beta 3 CIS precursor 532 U133A 217626_at 168 Hs.201967 NM_000299; plakophilin 1 CIS 533 U133A 218484_at 168 Hs.221447 NM_020142; NADH:ubiquinone CIS oxidoreductase MLRQ subunit homolog 534 U133A 218656_s_at 168 Hs.93765 NM_001442; fatty acid binding protein 4, CIS adipocyte 535 U133A 218718_at 168 Hs.43080 NM_000445; plectin 1, intermediate CIS filament binding protein 500 kDa 536 U133A 218918_at 168 Hs.8910 NM_000300; phospholipase A2, group IIA CIS (platelets, synovial fluid) 537 U133A 218960_at 168 Hs.414005 NM_019894; transmembrane protease, CIS serine 4 isoform 1 NM_183247; transmembrane protease, serine 4 isoform 2 538 U133A 219410_at 168 Hs.104800 NM_004692; NM_032727; internexin CIS neuronal intermediate filament protein, alpha 539 U133A 219922_s_at 168 Hs.289019 NM_030570; uroplakin 3B isoform a CIS NM_182683; uroplakin 3B isoform c NM_182684; uroplakin 3B isoform b 540 U133A 220026_at 168 Hs.227059 NM_001442; fatty acid binding protein 4, CIS adipocyte 541 U133A 220779_at 168 Hs.149195 NM_016233; peptidylarginine deiminase CIS type III 542 U133A 221204_s_at 168 Hs.326444 NM_018058; cartilage acidic protein 1 CIS 543 U133A 221660_at 168 Hs.247831 NM_000300; phospholipase A2, group IIA CIS (platelets, synovial fluid) 544 U133A 221671_x_at 168 Hs.377975 NM_000299; plakophilin 1 CIS 545 U133A 221854_at 168 Hs.313068 NM_000299; plakophilin 1 CIS 546 U133A 221872_at 168 Hs.82547 NM_001958; eukaryotic translation CIS elongation factor 1 alpha 2 547 U133A 200958_s_at 168 Hs.164067 NM_005625; syndecan binding protein CIS (syntenin) 548 U133A 201877_s_at 168 Hs.249955 NM_002719; gamma isoform of CIS regulatory subunit B56, protein phosphatase 2A isoform a NM_178586; gamma isoform of regulatory subunit B56, protein phosphatase 2A isoform b NM_178587; gamma isoform of regulatory subunit B56, protein phosphatase 2A isoform c NM_178588; gamma isoform of regulatory subunit B56, protein phosphatase 2A isoform d 549 U133A 201887_at 168 Hs.285115 NM_001560; interleukin 13 receptor, CIS alpha 1 precursor 550 U133A 202076_at 168 Hs.289107 NM_001166; baculoviral IAP repeat- CIS containing protein 2 551 U133A 202777_at 168 Hs.104315 NM_007373; soc-2 suppressor of clear CIS homolog 552 U133A 204640_s_at 168 Hs.129951 NM_003563; speckle-type POZ protein CIS 553 U133A 209004_s_at 168 Hs.5548 NM_012161; F-box and leucine-rich CIS repeat protein 5 isoform 1 NM_033535; F- box and leucine-rich repeat protein 5 isoform 2 554 U133A 209241_x_at 168 Hs.112028 NM_015716; misshapen/NIK-related CIS kinase isoform 1 NM_153827; misshapen/NIK-related kinase isoform 3 NM_170663; misshapen/NIK-related kinase isoform 2 555 U133A 209579_s_at 168 Hs.35947 NM_003925; methyl-CpG binding domain CIS protein 4 556 U133A 209630_s_at 168 Hs.444354 NM_012164; F-box and WD-40 domain CIS protein 2 557 U133A 212784_at 168 Hs.388236 NM_015125; capicua homolog CIS 558 U133A 212802_s_at 168 Hs.287266 CIS 559 U133A 212899_at 168 Hs.129836 NM_015076; cyclin-dependent kinase CIS (CDC2-like) 11 560 U133A 213633_at 168 Hs.97858 NM_018957; SH3-domain binding protein 1 CIS 561 U133A 217941_s_at 168 Hs.8117 NM_018695; erbb2 interacting protein CIS 562 U133A 218150_at 168 Hs.342849 NM_012097; ADP-ribosylation factor-like CIS 5 isoform 1 NM_177985; ADP-ribosylation factor-like 5 isoform 2

The relative expression level of at least one gene in a sample is determined, wherein at least one of said genes is selected from the genes of Table A, or preferably, the gene is one of the markers MBNL2, FABP4, UBE2C, or BIRC5. The sample according to the present invention may be any tissue sample or body fluid sample, but may preferably be epithelial tissue, such as epithelial tissue from the bladder. In particular the epithelial tissue may be mucosa. In another embodiment the sample is a urine sample comprising the tissue cells. The gene can also be one or more of the markers COL18A 1, COL4A 1, ACTA2, MSN and KPNA2, preferably when combined in a signature with one or more of the markers MBNL2, FABP4, UBE2C, or BIRC5. One can also have signatures with different combinations of the markers, which is preferred where combinations of markers lend additional weight or statistical significance to the likelihood of progression or non-progression. For example, scores reflecting the expression levels of two or more progression markers may correlate with a determination of a specified likelihood of progression, with greater statistical significance than such correlation when using fewer markers or only one marker.

The sample may be obtained by any suitable manner known to those skilled in the art, such as a biopsy of the tumor tissue, or a superficial sample scraped from tumor tissue. The sample may be prepared by forming a cell suspension made from the tissue, or by obtaining an extract from the tissue.

In one embodiment it is preferred that the sample comprises substantially only cells from said tissue, such as substantially only cells from mucosa of the bladder. The methods according to the invention may be used for determining any bladder cancer condition, wherein said condition leads to a change in relative expression level of at least one marker, and preferably a change in a variety of markers.

Thus, the cancer may be any malignant or premalignant condition, in particular in the bladder, such as a tumor or an adenocarcinoma, a carcinoma, a teratoma, a sarcoma, and/or a lymphoma, and/or carcinoma-in-situ, and/or dysplasia-in-situ.

The expression level of single markers or one or two or a few markers can be determined. Or, expression levels of several markers, forming an expression pattern for a signature, are obtained. In a preferred embodiment expression from at least one marker from a first group is determined, said first gene group representing markers being expressed at a higher level in one type of tissue, i.e. tissue in one stage or one risk group, in combination with determination of expression of at least one marker from a second group, said second group representing markers being expressed at a higher level in tissue from another stage or from another risk group.

Thereby, the validity of the prediction can increase, since expression levels from markers from more than one group are determined. However, determining the expression level of a single marker, whether belonging to the first group or second group is also within the scope of the invention. It is preferred that at least one marker monitored is MBNL2, FABP4, UBE2C, or BIRC5, or the marker monitored is selected among markers having a large change in expression level from normal cells to tumor cells, and may include COL18A1, COL4A1, ACTA2, MSN, KPNA2 and CDC25B.

Another approach is determination of an expression pattern from a variety of markers, in a signature, wherein the determination of the biological condition in the tissue relies on information from a signature rather than from expression of single genes or single markers. As noted above, the signature can include any of the markers MBNL2, FABP4, UBE2C, BIRC5, COL18A1, COL4A1, ACTA2, MSN, KPNA2 and CDC25B.

The following data relates to bladder tumors, and therefore the description has focused on the gene expression level as one way of identifying markers that lose or gain function in cancer tissue. Markers showing a remarkable down-regulation (or complete loss) or up-regulation (gene expression gained de novo) of the expression level, measured as the mRNA transcript, during the malignant progression in bladder from normal mucosa through Ta superficial tumors, and Carcinoa in situ (CIS) to T1, slightly invasive tumors, to T2, T3 and T4 which have spread to muscle or even further into lymph nodes or other organs, are monitored in the methods described herein, as are markers gaining importance during the differentiation from normal towards malignancy.

The invention relates to a variety of markers identified either by an EST identification number and/or by a gene identification number. Both types of identification numbers relate to identification numbers of UniGene database, NCBI, build 18.

The various markers have been identified using Affymetrix arrays (Affymetrix, Calif.) having the following product numbers:

HUGeneFL (sold in 2000-2002)

EOS Hu03 (customized Affymetrix array)

U133A (product #900367 sold in 2003)

The stage of a bladder tumor indicates how deeply the tumor has penetrated. Superficial tumors are termed Ta, and Carcinoma in situ (CIS), and T1, T2, T3 and T4 are used to describe increasing degrees of penetration into the muscle. The grade of a bladder tumor is expressed on a scale of I-IV (1-4) according to Bergkvist, A. et al. “Classification of bladder tumours based on the cellular pattern. Preliminary report of a clinical-pathological study of 300 cases with a minimum follow-up of eight years” Acta Chir. Scand., 1965, 130(4):371-8). The grade reflects the cytological appearance of the cells. Grade I cells are almost normal. Grade II cells are slightly deviant. Grade III cells are clearly abnormal. And Grade IV cells are highly abnormal. A special form of bladder malignancy is carcinoma-in-situ or dysplasia-in-situ in which the altered cells are located in-situ.

It is important to predict the prognosis of a cancer disease, as superficial tumors may require a less intensive treatment than invasive tumors. According to the invention the expression level of markers may be used to identify genes whose expression can be used to identify a certain stage and/or the prognosis of the disease. These markers are divided into those which can be used to identify Ta, Carcinoma in situ (CIS), T1, and T2 stages, as well as those identifying risk of recurrence or progression. In one aspect of the invention, measuring the transcript level of one or more of these markers may lead to a classifier that can add supplementary information to the information obtained from the pathological classification. For example gene expression levels that signify a T2 stage will be unfavorable to detect in a Ta tumor, as they may signal that the Ta tumor has the potential to become a T2 tumor. The opposite is probably also true, i.e., that an expression level that signifies Ta will be favorable to have in a T2 tumor. In that way independent information may be obtained from pathological classification, and a classification based on gene expression levels is made.

In the present context, a standard expression level is as defined, and includes the level of expression of a marker in a standard situation, such as a standard Ta tumor or a standard T2 tumor. For use in the present invention, standard expression levels are determined for each stage as well as for each group of progression, recurrence, and other prognostic indices. It is then possible to compare the results of a determination of the expression level from a gene of a given biological condition with a standard for each stage, progression, recurrence, and other indices, to obtain a classification of the biological condition.

From the standard expression levels of a number of genes, one can generate a reference pattern, which can be used in determining likelihood of progression. It is known from the histopathological classification of bladder tumors that some information is obtained from merely classifying into stage and grade of tumor. Accordingly, in one aspect, the invention relates to a method of predicting the prognosis of the biological condition by determining the stage of the biological condition, by determining an expression level of at least one marker, wherein said marker is one or more of gene Nos. 1 to 562. In this aspect information about the stage directly reveals information about the prognosis as well. An example hereof is when a bladder tumor is classified, for example, as stage T2—then the prognosis for the bladder tumor is obtained directly from the prognosis related generally to stage T2 tumors. In one embodiment the markers for predicting the prognosis by establishing the stage of the tumor may be selected from markers No. 1 to gene No. 188. Markers for predicting the prognosis by establishing the stage of the tumor can also include any of MBNL2, FABP4, UBE2C, BIRC5, COL18A1, COL4A1, ACTA2, MSN, KPNA2 and CDC25B.

It is often preferred that the expression level of more than one marker is determined, such as the expression level of at least two markers, to as many markers as deemed relevant. As discussed above, in relation to bladder cancer the stages of a bladder tumor are selected from bladder cancer stages Ta, Carcinoma in situ, T1, T2, T3 and T4. In one embodiment the determination of a stage comprises assaying at least the expression of Ta stage marker from a Ta stage marker group, at least one expression of a CIS marker, at least the expression of T1 stage marker from a T1 stage marker group, at least the expression of T2 stage marker from a T2 stage marker group, and more preferably assaying at least the expression of Ta stage marker from a Ta stage marker group, at least one expression of a marker gene, at least one expression of T1 stage marker from a T1 stage marker group, at least the expression of T2 stage marker from a T2 stage marker group, at least the expression of T3 stage marker from a T3 stage marker group, at least the expression of T4 stage marker from a T4 stage marker group wherein at least one marker from each gene marker group is expressed in a significantly different amount in that stage than in one of the other stages.

Preferably, the markers selected may be a marker from a group being expressed in a significantly higher amount in that stage than in one of the other stages as compared to normal controls. The marker(s) selected may be a marker from a group being expressed in a significantly lower amount in that stage than in one of the other stages.

In another embodiment the invention relates to a method of predicting the prognosis of a biological condition by obtaining information in addition to the stage classification as such. As described above, by determining gene expression levels that signify a T2 stage in a tumor otherwise classified as a Ta tumor, the expression levels signal that the Ta tumor has the potential to become a T2 tumor (“harmful” markers). The opposite can also be true, that an expression level that signifies Ta will be favorable to have in a T2 tumor (“protective” markers). Some markers are particularly relevant as they relate to this additional information. Also, in one embodiment the invention relates to a further method of predicting the prognosis of a biological condition by obtaining information in addition to the stage classification as such. For example, determination of squamous metaplasia in a tumor, in particular in a T2 stage tumor, is indicative of risk of progression. In particular the markers may be selected from gene Nos. 215 to No. 232. In another embodiment the invention relates to markers bearing information of recurrence of the biological condition as such. In particular the markers may be selected from gene Nos. 189 to No. 214. An alternative is to determine a first expression level of at least one marker from a first group, wherein the first group is representative of markers wherein expression is increased in case of recurrence, genes No. 189 to gene No. 199 (recurrence genes), and to also determine a second expression level of at least one marker from a gene group, wherein the second group is selected from the group of markers wherein expression is increased in case of non-recurrence, genes No. 200 to No. 214 (non-recurrence genes), and correlate the first expression level to a standard expression level for progressors, and/or the second expression level to a standard expression level for non-progressors to predict the prognosis of the biological condition in the animal tissue.

Furthermore, in another embodiment the invention relates to markers bearing information of progression or non-progression including gene Nos. 233 to No. 446. More preferably the markers may be selected from gene Nos. 255, 273, 279, 280, 281, 282, 287, 295 (MBNL2), 300, 311, 317, 320, 333, 346, 347, 349, 352, 364, 365, 373, 383, 386, 390, 394, 401, 407, 414, 417, 426, 427, 428, 433, 434, 435, 436, 437 (BIRC5), 438, 439, 440, 441, 442, 443, 444, 445, 446, and 467 (FABP4).

Furthermore, it is within the scope of the invention to predict the prognosis of a biological condition in animal tissue by determining the expression level of at least two markers, by determining a first expression level of at least one marker from a first group, wherein the first group is selected from the group of gene Nos. 237, 238, 239, 240, 241, 242, 243, 245, 246, 247, 248, 250, 253, 254, 257, 258, 260, 263, 264, 265, 267, 270, 271, 272, 278, 283, 284, 287, 288, 290, 291, 292, 294, 297, 298, 300, 302, 303, 305, 309, 310, 315, 316, 317, 318, 319, 321, 324, 329, 335, 336, 337, 339, 340, 344, 346, 347, 354, 356, 358, 359, 362, 364, 365, 368, 369, 371, 372, 277, 378, 379, 380, 381, 382, 383, 384, 388, 391, 393, 395, 396, 397, 399, 402, 403, 404, 409, 413, 417, 419, 420, 421, 422, 423, 425, 427, 429, 430, 431, 432, 437 (BIRC5), 444 (progressor genes), and determining a second expression level of at least one marker from a second group, wherein the second group is selected from the group of genes Nos. 233, 234, 235, 236, 244, 249, 251, 252, 255, 256, 259, 261, 262, 266, 268, 269, 273, 274, 275, 276, 277, 279, 280, 281, 282, 285, 286, 289, 293, 295 (MBNL2), 296, 299, 301, 304, 306, 307, 308, 311, 312, 313, 314, 320, 322, 323, 325, 326, 327, 328, 330, 331, 332, 333, 334, 338, 341, 342, 343, 345, 348, 349, 350, 351, 352, 353, 355, 357, 360, 361, 363, 366, 367, 370, 373, 374, 375, 376, 385, 386, 387, 389, 390, 392, 394, 398, 400, 401, 405, 406, 407, 408, 410, 411, 412, 414, 415, 416, 418, 424, 426, 428, 433, 434, 435, 436, 438, 439, 440, 441, 442, 443, 445, 446, 467 (FABP4) (non-progressor genes), and correlating the first expression level to a standard expression level for progressors, and/or the second expression level to a standard expression level for non-progressors to predict the prognosis of the biological condition in the animal tissue.

In particular the markers of the first group and the second group for predicting the prognosis of a Ta stage tumor may be selected from markers selected from the group of progression/non-progression genes described above.

In yet another embodiment the present invention offers the possibility to predict the presence or absence of carcinoma in situ in the same organ as the primary tumor. An example hereof is where a Ta bladder tumor is present, predicting whether in addition to the Ta tumor carcinoma in situ (CIS) is present. The presence of carcinoma in situ in a bladder containing a superficial Ta tumor is a signal that the Ta tumor has the potential of recurrence and invasiveness. Accordingly, by predicting the presence of carcinoma in situ important information about the prognosis is obtained. In this context, markers for predicting the presence of carcinoma in situ for a Ta stage tumor may be selected from gene Nos. 447 to No. 562. Alternatively or preferably the markers are selected from gene Nos. 447, 448, 449, 450, 451, 452, 453, 454, 455, 456, 457, 458, 459, 460, 461, 462, 463, 464, 465, 466, 467 (FABP4), 468, 469, 470, 471, 472, 473, 474, 475, 476, 477, 478, 479, 480, 481, 482, 483, 484, 485, 486, 487, 488, 489, 490, 491, 492, 493, 494, 495, 496, 497, 498, 499, 500, 501, 502, 503, 504, 505, 506, 507, 508, 509, 510, 511, 512, 513, 514, 515, 516, 517, 518, 519, 520, 521, 522, 523, 524, 525, 526, 527, 528, 529, 530, 531, 532, 533, 534, 535, 536, 537, 538, 539, 540, 541, 542, 543, 544, 545, 546, or from gene Nos. 547, 548, 549, 550, 551, 552, 553, 554, 555, 556, 557, 558, 559, 560, 561, 562.

It is also an alternative to determine a first expression level of at least one marker from a first group, wherein expression level of this marker is increased in case of CIS, i.e., genes Nos. 447, 448, 449, 450, 451, 452, 454, 455, 456, 457, 458, 459, 462, 468, 474, 478, 484, 489, 491, 493, 495, 500, 501, 502, 504, 505, 506, 507, 508, 509, 510, 511, 512, 513, 514, 518, 519, 520, 522, 523, 524, 525, 529, 531, 534, 535, 536, 538, 544, 546, 547, 548, 549, 550, 551, 552, 553, 555, 556, 558, 559, 561, 562 (CIS genes), and to determine an expression level of at least one marker from a second group, wherein expression level of this marker is increased in case of no CIS, genes Nos. 453, 460, 461, 463, 464, 465, 466, 467 (FABP4), 469, 470, 471, 472, 473, 475, 476, 477, 479, 480, 481, 482, 483, 485, 486, 487, 488, 490, 492, 494, 496, 497, 498, 499, 503, 515, 516, 517, 521, 526, 527, 528, 530, 532, 533, 537, 539, 540, 541, 542, 543, 545, 554, 557, 560 (non-CIS genes), and correlate the first expression level to a standard expression level for CIS, and/or the second expression level to a standard expression level for non-CIS to predict the prognosis of the cancer.

Another alternative when determining the expression level of at least one marker from a first group and at least one marker from a second group is that the expression level of more than one marker from each group is determined. In one embodiment, the stage of the biological condition is determined before the prediction of prognosis. The stage may be determined by any suitable means such as by histological examination of the tissue or by genotyping of the tissue, preferably by genotyping of the tissue such as described herein or as described in international application WO 02/02804 incorporated herein by reference.

In another aspect the invention relates to determining the stage of a biological condition in animal tissue, comprising collecting a sample of cells from the tissue, determining an expression level of at least one marker selected from gene Nos. 1 to No. 562, correlating the markers' gene expression level to at least one standard level of expression relating to the stage of the condition. In particular the expression level of at least one marker from gene Nos. 1-457 and gene Nos. 459-535 and gene Nos. 537-562 is determined.

In one embodiment the expression level of at least two markers is determined by determining the expression of at least a first stage marker from a first group and at least a second stage marker from a second group, wherein at least one of said markers has a higher gene expression level in said first stage than in said second stage, and the other marker has a lower gene expression level in said first stage than in said second stage, and correlating the expression level of the assessed genes to a standard level of expression indicating the stage of the condition.

In general, markers being downregulated for higher stage tumors as well as for progression and recurrence may be of importance as predictive markers for the disease, as they may signal a poor outcome or an aggressive disease course. Furthermore, they may be important targets for therapy because restoring their expression level, e.g. by gene therapy, or substitution with those peptide products or small molecules with a similar biological effect, may suppress the malignant growth.

Markers that are up-regulated (or gained de novo) during the malignant progression of bladder cancer from normal tissue through Ta, T1, T2, T3 and T4 are also within the scope of the Invention. These markers are potential oncogenes and may create or enhance the malignant growth of the cells. The expression level of these markers may serve as predictive markers for the disease course and treatment response, i.e., a high level may signal an aggressive disease course, and they may serve as targets for therapy, as blocking these markers by, e.g., anti-sense therapy, or by biochemical means could inhibit, or slow the tumor growth.

The markers used according to the invention show a sufficient difference in expression from one group to another and/or from one stage to another to use them as a classifier for the group and/or stage. Thus, comparison of an expression pattern from a signature to another expression pattern from another signature may indicate a change in stage, or identify a grouping. Alternatively, changes in intensity of expression may be scored, either as increases or decreases. Any significant change can be used. Typical changes which are more than 2-fold are suitable. Changes which are greater than 5-fold are highly suitable. The invention in particular relates to methods using markers wherein a significant change in gene expression level is seen between two groups.

As described above the invention relates to the use of information about expression levels. In one embodiment the expression patterns from signatures are obtained. Thus, the invention relates to a method of determining such an expression pattern, comprising: collecting a sample of bladder cells and/or gene products from bladder cells, determining the expression level of more than one marker in the sample, said marker being selected from gene Nos. 1 to 562, and obtaining an expression pattern for the signature.

The expression pattern preferably relates to one or more of the markers discussed above with respect to prognosis relating to stage, progression, recurrence and/or CIS.

In order to predict prognosis and/or stages it is preferred to determine an expression pattern of a signature from a cell sample preferably independent of the proportion of submucosal, muscle and connective tissue cells present. Expression is determined from one or more genes in a sample comprising cells, said genes being selected from the same genes as discussed above and shown in the tables.

It is an object of the invention that characteristic patterns of expression of signatures can be used to characterize different types of tissue. Thus, for example gene expression patterns can be used to characterize stages and grades of bladder tumors. Similarly, gene expression patterns can be used to distinguish cells having a bladder origin from other cells. Moreover, expression products which routinely contaminate bladder tumor biopsies have been identified, and such expression products can be removed or subtracted from patterns obtained from bladder biopsies. Further, the gene expression patterns of single-cell solutions of bladder tumor cells have been found to be substantially without interfering expression of contaminating muscle, submucosal, and connective tissue cells.

The markers in a signature monitored generally are not genes which are expressed in the submucosal, muscle, and connective tissue. A pattern of expression is formed for the sample which is independent of the proportion of submucosal, muscle, and connective tissue cells in the sample.

In another aspect of the invention, a method of determining an expression pattern of signatures from a cell sample is provided. Expression is determined from one or more markers in a sample comprising cells. A first pattern of expression is thereby formed for the sample. Genes which are expressed in submucosal, muscle, and connective tissue cells are removed from the first pattern of expression, forming a second pattern of expression which is independent of the proportion of submucosal, muscle, and connective tissue cells in the sample.

Another embodiment of the invention provides a method for determining an expression pattern of a signature from a bladder mucosa or bladder cancer cell independent of the proportion of submucosal, muscle, and connective tissue cells present in the sample. Expression is determined from one or more markers in a sample comprising bladder mucosa or bladder cancer cells; the expression determined forms a first pattern of expression. A second pattern of expression which was formed using the one or more genes and a sample comprising predominantly submucosal, muscle, and connective tissue cells, is subtracted from the first pattern of expression, forming a third pattern of expression. The third pattern of expression reflects expression of the bladder mucosa or bladder cancer cells independent of the proportion of submucosal, muscle, and connective tissue cells present in the sample.

In one embodiment the invention provides a method to predict the prognosis of a bladder tumor as described above. A first pattern of expression is determined from more than one marker in a bladder tumor sample. The first pattern is compared to one or more reference patterns of expression determined for bladder tumors at different stages and/or in different groups. The reference patterns which share the most similarity with the first pattern are identified. The stage of the reference pattern with the maximum similarity indicates the stage of the tumor in the bladder tumor sample.

Since a biopsy of the tissue often contains more extraneous tissue material such as connective tissue than the tissue to be examined, when the tissue to be examined is epithelial or mucosa, the invention also relates to methods wherein the expression pattern of the tissue is independent of the amount of connective tissue in the sample.

Biopsies contain epithelial cells that most often are the targets for the studies, but in addition contain many other cells that contaminate the epithelial cell fraction to a varying extent. The contaminants include histiocytes, endothelial cells, leukocytes, nerve cells, muscle cells, etc. Micro dissection is the method of choice for DNA examination, but in the case of expression studies this procedure is difficult due to RNA degradation during the procedure. The epithelium may be removed and the expression in the remaining submucosa and underlying connective tissue (the bladder wall) monitored. Genes expressed at high or low levels in the bladder wall should be interrogated when performing expression monitoring of the mucosa and tumors. A similar approach could be used for studies of epithelia in other organs. In one embodiment of the invention, normal mucosa lining the bladder lumen of bladders from cancer subjects is scraped off. Then biopsies are taken from the denuded submucosa and connective tissue, reaching approximately 5 mm into the bladder wall, and immediately disintegrated in guanidinium isothiocyanate. Total RNA may be extracted, pooled, and polyA mRNA may be prepared from the pool followed by conversion to double-stranded cDNA and in vitro transcription into cRNA containing biotin-labeled CTP and UTP.

Genes that are expressed and genes that are not expressed in the bladder wall can both interfere with the interpretation of the expression in a biopsy, and should be considered when interpreting expression intensities in tumor biopsies, as the bladder wall component of a biopsy varies in amount from biopsy to biopsy.

When having determined the pattern of genes expressed in bladder wall components, said pattern may be subtracted from a pattern of a signature obtained from the sample, resulting in a third pattern related to the mucosa (epithelial) cells.

In another embodiment of the invention a method is provided for determining an expression pattern of a signature from a bladder tissue sample independent of the proportion of submucosal, muscle and connective tissue cells present. A single-cell suspension of disaggregated bladder tumor cells is isolated from a bladder tissue sample comprising bladder tumor cells, submucosal cells, muscle cells, and connective tissue cells. A pattern of expression is thus formed for the signature in the sample which is independent of the proportion of submucosal, muscle, and connective tissue cells in the bladder tissue sample.

Yet another method relates to the elimination of mRNA from bladder wall components before determining the expression pattern, e.g. by filtration and/or affinity chromatography to remove mRNA related to the bladder wall. Working with tumor material requires biopsies or body fluids suspected of containing relevant cells. Working with RNA requires freshly frozen or immediately processed biopsies, or chemical pretreatment of the biopsy. Apart from the cancer tissue, biopsies do inevitably contain many different cell types, such as cells present in the blood, connective and muscle tissue, endothelium, etc. In the case of DNA studies, microdissection or laser capture are methods of choice, however the time-dependent degradation of RNA makes it difficult to perform manipulation of the tissue for more than a few minutes. Furthermore, studies of expressed sequences may be difficult on the few cells obtained via microdissection or laser capture, as these cells may have an expression pattern that deviates from the predominant pattern in a tumor due to large intratumoral heterogeneity.

In the present context, high density expression arrays may be used to evaluate the impact of bladder wall components in bladder tumor biopsies, and single cell solutions may be a means of eliminating the contaminants. The results of these evaluations permit for the design of methods of evaluating bladder samples without the interfering background noise caused by ubiquitous contaminating submucosal, muscle, and connective tissue cells. The evaluating assays of the invention may be of any type.

While high density expression arrays can be used, other techniques are also contemplated. These include other techniques for assaying for specific mRNA species, including RT-PCR and Northern Blotting, as well as techniques for assaying for particular protein products, such as ELISA, Western blotting, and enzyme assays. Gene expression patterns or scores according to the present invention are determined by measuring any gene product. A pattern or score may be for one or more genes or markers. RNA or protein can be isolated and assayed from a test sample using any techniques known in the art. They can for example be isolated from a fresh or frozen biopsy, from formalin-fixed tissue, or from body fluids, such as blood, plasma, serum, urine, or sputum.

Expression of genes may in general be detected by either detecting mRNA from the cells and/or detecting expression products, such as peptides and proteins. The detection of mRNA expression may be a tool for determining the developmental stage of a cell type which may be definable by its pattern of expression of messenger RNA. Where a pattern is shown to be characteristic of a stage, said stage may be defined by that particular pattern of messenger RNA expression. The mRNA population is a good determinant of a developmental stage, and may be correlated with other structural features of the cell. In this manner, cells at specific developmental stages will be characterized by the intracellular environment, as well as the extracellular environment.

The present invention also allows the combination of classifiers of tumors based in part upon antigens and in part upon mRNA expression. In one embodiment, the two may be combined in a single incubation step. A particular incubation condition may be found which is compatible with both hybridization recognition and non-hybridization recognition molecules. Thus, e.g. an incubation condition may be selected which allows both specificity of antibody binding and specificity of nucleic acid hybridization. This allows simultaneous performance of both types of interactions on a single matrix in one assay. Again, where developmental mRNA patterns are correlated with structural features, or with probes which are able to hybridize to intracellular mRNA populations, a cell sorter may be used to sort specifically those cells having desired mRNA population patterns.

It is within the general scope of the invention to provide methods for the detection of mRNA. Such methods often involve sample extraction, PCR amplification, nucleic acid fragmentation and labeling, extension reactions, and transcription reactions. The nucleic acid (either genomic DNA or mRNA) may be isolated from the sample according to any of a number of methods well known to those of skill in the art. One of skill will appreciate that where alterations in the copy number of a gene are to be detected; genomic DNA is preferably isolated and analyzed. Conversely, where gene expression levels are to be detected, preferably RNA (mRNA) is isolated and analyzed.

Methods of isolating total RNA are well known to those of skill in the art. In one embodiment, the total nucleic acid is isolated from a given sample using, for example, an acid guanidinium-phenol-chloroform extraction method and polyA selection for mRNA using oligo dT column chromatography or by using beads or magnetic beads with (dT)n groups attached (see, e.g., Sambrook et al., Molecular Cloning: A Laboratory Manual (2nd ed.), Vols. 1-3, Cold Spring Harbor Laboratory, (1989), or Current Protocols in Molecular Biology, F. Ausubel et al., ed. Greene Publishing and Wiley-Interscience, New York (1987)).

The sample may be from tissue and/or body fluids, as defined elsewhere herein. Before analyzing the sample, e.g., on an oligonucleotide array, it will often be desirable to perform one or more sample preparation operations upon the sample. Typically, these sample preparation operations will include manipulations such as extraction of intracellular material, e.g., nucleic acids from whole cell samples, viruses, amplification of nucleic acids, fragmentation, transcription, labeling and/or extension reactions. One or more of these various operations may be readily incorporated into the methods of the invention.

DNA extraction may be relevant under circumstances where possible mutations in the genes are to be determined in addition to the determination of expression of the genes. For those embodiments where whole cells, or other tissue samples are being analyzed, it will typically be necessary to extract the nucleic acids from the cells or viruses, prior to continuing with the various sample preparation operations. Accordingly, following sample collection, nucleic acids may be liberated from the collected cells, viral coat etc. into a crude extract followed by additional treatments to prepare the sample for subsequent operations, such as denaturation of contaminating (DNA binding) proteins, purification, filtration and desalting.

Liberation of nucleic acids from the sample cells, and denaturation of DNA binding proteins may generally be performed by physical or chemical methods. For example, chemical methods generally employ lysing agents to disrupt the cells and extract the nucleic acids from the cells, followed by treatment of the extract with chaotropic salts such as guanidinium isothiocyanate or urea to denature any contaminating and potentially interfering proteins.

Alternatively, physical methods may be used to extract the nucleic acids and denature DNA binding proteins, such as employing physical protrusions within microchannels or sharp edged particles to pierce cell membranes and extract their contents. Combinations of such structures with piezoelectric elements for agitation can provide suitable shear forces for lysis.

More traditional methods of cell extraction may also be used, e.g., employing a channel with restricted cross-sectional dimension which causes cell lysis when the sample is passed through the channel with sufficient flow pressure. Alternatively, cell extraction and denaturing of contaminating proteins may be carried out by applying an alternating electrical current to the sample. More specifically, the sample of cells is flowed through a microtubular array while an alternating electric current is applied across the fluid flow. Subjecting cells to ultrasonic agitation, or forcing cells through microgeometry apertures, thereby subjecting the cells to high shear stress resulting in rupture, are also possible extraction methods.

Following extraction, it will often be desirable to separate the nucleic acids from other elements of the crude extract, e.g. denatured proteins, cell membrane particles and salts. Removal of particulate matter is generally accomplished by filtration or flocculation. Further, where chemical denaturing methods are used, it may be desirable to desalt the sample prior to proceeding to the next step. Desalting of the sample and isolation of the nucleic acid may generally be carried out in a single step, e.g. by binding the nucleic acids to a solid phase and washing away the contaminating salts, or performing gel filtration chromatography on the sample. Suitable solid supports for nucleic acid binding include e.g. diatomaceous earth or silica (i.e., glass wool). Suitable gel exclusion media, also well known in the art, may be readily incorporated into the devices of the present invention and is commercially available from, e.g., Pharmacia and Sigma Chemical.

Alternatively, desalting methods may generally take advantage of the high electrophoretic mobility and negativity of DNA compared to other elements. Electrophoretic methods may also be utilized in the purification of nucleic acids from other cell contaminants and debris. Upon application of an appropriate electric field, the nucleic acids present in the sample will migrate toward the positive electrode and become trapped on the capture membrane. Sample impurities remaining free of the membrane are then washed away by applying an appropriate fluid flow. Upon reversal of the voltage, the nucleic acids are released from the membrane in a substantially purer form. Further, coarse filters may also be overlaid on the barriers to avoid any fouling of the barriers by particulate matter, proteins or nucleic acids, thereby permitting repeated use.

In a similar aspect, the high electrophoretic mobility of nucleic acids with their negative charges may be utilized to separate nucleic acids from contaminants by utilizing a short column of a gel or other appropriate matrices or gels which will slow or retard the flow of other contaminants, while allowing the faster nucleic acids to pass.

This invention provides nucleic acid affinity matrices that bear a large number of different nucleic acid affinity ligands, allowing the simultaneous selection and removal of a large number of preselected nucleic acids from the sample. Methods of producing such affinity matrices are also provided. In general the methods involve the steps of a) providing a nucleic acid amplification template array comprising a surface to which are attached at least 50 oligonucleotides having different nucleic acid sequences, and wherein each different oligonucleotide is localized in a predetermined region of said surface, the density of said oligonucleotides is greater than about 60 different oligonucleotides per cm², and all of said different oligonucleotides have an identical terminal 3′ nucleic acid sequence and an identical terminal 5′ nucleic acid sequence; b) amplifying said multiplicity of oligonucleotides to provide a pool of amplified nucleic acids; and c) attaching the pool of nucleic acids to a solid support.

For example, nucleic acid affinity chromatography is based on the tendency of complementary, single-stranded nucleic acids to form a double-stranded or duplex structure through complementary base pairing. A nucleic acid (either DNA or RNA) can easily be attached to a solid substrate (matrix) where it acts as an immobilized ligand that interacts with and forms duplexes with complementary nucleic acids present in a solution contacted to the immobilized ligand. Unbound components can be washed away from the bound complex to either provide a solution lacking the target molecules bound to the affinity column, or to provide the isolated target molecules themselves. The nucleic acids captured in a hybrid duplex can be separated and released from the affinity matrix by denaturation either through heat, adjustment of salt concentration, or the use of a destabilizing agent such as formamide, TWEEN™-20 denaturing agent, or sodium dodecyl sulfate (SOS).

Affinity columns (matrices) are typically used either to isolate a single nucleic acid typically by providing a single species of affinity ligand. Alternatively, affinity columns bearing a single affinity ligand (e.g. oligo dT columns) have been used to isolate a multiplicity of nucleic acids where the nucleic acids all share a common sequence (e.g. a polyA).

The type of affinity matrix used depends on the purpose of the analysis. For example, where it is desired to analyze mRNA expression levels of particular genes in a complex nucleic acid sample (e.g., total mRNA) it is often desirable to eliminate nucleic acids produced by genes that are constitutively over-expressed and thereby tend to mask gene products expressed at characteristically lower levels. Thus, in one embodiment, the affinity matrix can be used to remove a number of preselected gene products (e.g., actin, GAPDH, etc.). This is accomplished by providing an affinity matrix bearing nucleic acid affinity ligands complementary to the gene products (e.g., mRNAs or nucleic acids derived therefrom) or to subsequences thereof. Hybridization of the nucleic acid sample to the affinity matrix will result in duplex formation between the affinity ligands and their target nucleic acids. Upon elution of the sample from the affinity matrix, the matrix will retain the duplexed nucleic acids, leaving a sample depleted of the over-expressed target nucleic acids.

The affinity matrix can also be used to identify unknown mRNAs or cDNAs in a sample. Where the affinity matrix contains nucleic acids complementary to every known gene (e.g., in a cDNA library, DNA reverse transcribed from an mRNA, mRNA used directly or amplified or polymerized from a DNA template) in a sample, capture of the known nucleic acids by the affinity matrix leaves a sample enriched for those nucleic acid sequences that are unknown. In effect, the affinity matrix is used to perform a subtractive hybridization to isolate unknown nucleic acid sequences. The unknown sequences can then be purified and sequenced according to standard methods.

Another type of affinity matrix can also be used to capture (isolate) and thereby purify unknown nucleic acid sequences. For example, an affinity matrix can be prepared that contains nucleic acid (affinity ligands) that are complementary to sequences not previously identified, or not previously known to be expressed in a particular nucleic acid sample. The sample is then hybridized to the affinity matrix and those sequences that are retained on the affinity matrix are “unknown” nucleic acids. The retained nucleic acids can be eluted from the matrix (e.g. at increased temperature, increased destabilizing agent concentration, or decreased salt) and the nucleic acids can then be sequenced according to standard methods. Similarly, the affinity matrix can be used to efficiently capture (isolate) a number of known nucleic acid sequences. Again, the matrix is prepared bearing nucleic acids complementary to those nucleic acids it is desired to isolate. The sample is contacted with the matrix under hybridization conditions. The non-hybridized material is washed off the matrix leaving the desired sequences bound. The hybrid duplexes are then denatured providing a pool of the isolated nucleic acids. The different nucleic acids in the pool can be subsequently separated according to standard methods (e.g. gel electrophoresis).

As indicated above, the affinity matrices can be used to selectively remove nucleic acids from virtually any sample containing nucleic acids (e.g. in a cDNA library, DNA reverse transcribed from an mRNA, mRNA used directly or amplified, or polymerized from a DNA template, and so forth). The nucleic acids adhering to the column can be removed by washing with a low salt concentration buffer, a buffer containing a destabilizing agent such as formamide, or by elevating the column temperature.

In one particularly preferred embodiment, the affinity matrix can be used in a method to enrich a sample for unknown RNA sequences (e.g. expressed sequence tags (ESTs)). The method involves first providing an affinity matrix bearing a library of oligonucleotide probes specific to known RNA (e.g., EST) sequences. Then, RNA from undifferentiated and/or unactivated cells and RNA from differentiated or activated or pathological (e.g., transformed) cells, or cells otherwise having a different metabolic state, are separately hybridized against the affinity matrices to provide two pools of RNAs lacking the known RNA sequences.

In one embodiment, the affinity matrix is packed into a columnar casing. The sample is then applied to the affinity matrix (e.g. injected onto a column or applied to a column by a pump such as a sampling pump driven by an auto-sampler). The affinity matrix (e.g. an affinity column) bearing the sample is subjected to conditions under which the nucleic acid probes comprising the affinity matrix hybridize specifically with complementary target nucleic acids. Such conditions are accomplished by maintaining appropriate pH, salt and temperature conditions to facilitate hybridization, as discussed above.

For a number of applications, it may be desirable to extract and separate messenger RNA from cells, cellular debris, and other contaminants. As such, the device of the present invention may, in some cases, include an mRNA purification chamber or channel. In general, such purification takes advantage of the poly-A tails on mRNA. In particular and as noted above, poly-T oligonucleotides may be immobilized within a chamber or channel of the device, or upon a solid support incorporated within the chamber or channel, to serve as affinity ligands for mRNA. Immobilization of oligonucleotides on the surface of the chambers or channels may be carried out by methods described herein including, e.g., oxidation and silanation of the surface followed by standard DMT synthesis of the oligonucleotides. In operation, the lysed sample is introduced to a high salt solution to increase the ionic strength for hybridization, whereupon the mRNA will hybridize to the immobilized poly-T. The mRNA bound to the immobilized poly-T oligonucleotides is then washed free in a low ionic strength buffer. The poly-T oligonucleotides may be immobilized upon porous surfaces, e.g., porous silicon, zeolites silica xerogels, scintered particles, or other solid supports. Following sample preparation, the sample can be subjected to one or more different analysis operations. A variety of analysis operations may generally be performed, including size based analysis using, e.g., microcapillary electrophoresis, and/or sequence based analysis using, e.g., hybridization to an oligonucleotide array. In the latter case, the nucleic acid sample may be probed using an array of oligonucleotide probes. Oligonucleotide arrays generally include a substrate having a large number of positionally distinct oligonucleotide probes attached to the substrate. These arrays may be produced using mechanical or light directed synthesis methods which incorporate a combination of photolithographic methods and solid phase oligonucleotide synthesis methods.

The basic strategy for light directed synthesis of oligonucleotide arrays is as follows. The surface of a solid support, modified with photosensitive protecting groups is illuminated through a photolithographic mask, yielding reactive hydroxyl groups in the illuminated regions. A selected nucleotide, typically in the form of a 3′-O-phosphoramidite-activated deoxynucleoside (protected at, the 5′ hydroxyl with a photosensitive protecting group), is then presented to the surface and coupling occurs at the sites that were exposed to light. Following capping and oxidation, the substrate is rinsed and the surface is illuminated through a second mask to expose additional hydroxyl groups for coupling. A second selected nucleotide (e.g., 5′-protected, 3′-O-phosphoramidite-activated deoxynucleoside) is presented to the surface. The selective deprotection and coupling cycles are repeated until the desired set of products is obtained. Since photolithography is used, the process can be readily miniaturized to generate high density arrays of oligonucleotide probes. Furthermore, the sequence of the oligonucleotides at each site is known. See Pease et al. Mechanical synthesis methods are similar to the light directed methods except they involve mechanical direction of fluids for deprotection and addition in the synthesis steps.

For some embodiments, oligonucleotide arrays may be prepared having all possible probes of a given length. The hybridization pattern of the target sequence on the array may be used to reconstruct the target DNA sequence. Hybridization analysis of large numbers of probes can be used to sequence long stretches of DNA or provide an oligonucleotide array which is specific and complementary to a particular nucleic acid sequence. For example, in particularly preferred aspects, the oligonucleotide array will contain oligonucleotide probes which are complementary to specific target sequences and individual or multiple mutations of these. Such arrays are particularly useful in the diagnosis of specific disorders which are characterized by the presence of a particular nucleic acid sequence.

Following sample collection and nucleic acid extraction, the nucleic acid portion of the sample is typically subjected to one or more preparative reactions. These preparative reactions include in vitro transcription, labeling, fragmentation, amplification and other reactions. Nucleic acid amplification increases the number of copies of the target nucleic acid sequence of interest. A variety of amplification methods are suitable for use in the methods and devices of the present invention, including for example, the polymerase chain reaction method or (PCR), the ligase chain reaction (LCR), self sustained sequence replication, and nucleic acid based sequence amplification (NASBA). The latter two amplification methods involve isothermal reactions based on isothermal transcription, which produces both single stranded RNA (ssRNA) and double stranded DNA (dsDNA) as the amplification products in a ratio of approximately 30 or 100 to 1, respectively. As a result, where these latter methods are employed, sequence analysis may be carried out using a substrate with oligonucleotides attached which are complementary to either DNA or RNA.

Frequently, it is desirable to amplify the nucleic acid sample prior to hybridization. One of skill in the art will appreciate that whatever amplification method is used, if a quantitative result is desired, especially where that is how expression levels are determined, care must be taken to use a method that maintains or controls for the relative frequencies of the amplified nucleic acids.

PCR

Methods of “quantitative” amplification are well known to those of skill in the art. For example, quantitative PCR involves simultaneously co-amplifying a known quantity of a control sequence using the same primers. This provides an internal standard that may be used to calibrate the PCR reaction. The high density array may then include probes specific to the internal standard for quantification of the amplified nucleic acid. Thus, in one embodiment, this invention provides for a method of optimizing a probe set for detection of a particular gene. Generally, this method involves providing a high density array containing a multiplicity of probes of one or more particular length(s) that are complementary to subsequences of the mRNA transcribed by the target gene. In one embodiment, the high density array may contain every probe of a particular length that is complementary to a particular mRNA. The probes of the high density array are then hybridized with their target nucleic acid alone, and then hybridized with a high complexity, high concentration nucleic acid sample that does not contain the targets complementary to the probes. Thus, for example, where the target nucleic acid is an RNA, the probes are first hybridized with their target nucleic acid alone and then hybridized with RNA made from a cDNA library (e.g., reverse transcribed polyA⁺ mRNA) where the sense of the hybridized RNA is opposite that of the target nucleic acid (to insure that the high complexity sample does not contain targets for the probes). Those probes that show a strong hybridization signal with their target and little or no cross-hybridization with the high complexity sample are preferred probes for use in such high density arrays.

PCR amplification generally involves the use of one strand of the target nucleic acid sequence as a template for producing a large number of complements to that sequence. Generally, two primer sequences complementary to different ends of a segment of the complementary strands of the target sequence hybridize with their respective strands of the target sequence, and in the presence of polymerase enzymes and nucleoside triphosphates, the primers are extended along the target sequence. The extensions are melted from the target sequence and the process is repeated, this time with the additional copies of the target sequence synthesized in the preceding steps. PCR amplification typically involves repeated cycles of denaturation, hybridization and extension reactions to produce sufficient amounts of the target nucleic acid. The first step of each cycle of the PCR involves the separation of the nucleic acid duplex formed by the primer extension. Once the strands are separated, the next step in PCR involves hybridizing the separated strands with primers that flank the target sequence. The primers are then extended to form complementary copies of the target strands. For successful PCR amplification, the primers are designed so that the position at which each primer hybridizes along a duplex sequence is such that an extension product synthesized from one primer, when separated from the template (complement), serves as a template for the extension of the other primer. The cycle of denaturation, hybridization, and extension is repeated as many times as necessary to obtain the desired amount of amplified nucleic acid.

In PCR methods, strand separation is normally achieved by heating the reaction to a sufficiently high temperature for a sufficient time to cause the denaturation of the duplex, but not to cause an irreversible denaturation of the polymerase. Typical heat denaturation involves temperatures ranging from about 80° C. to 105° C. for times ranging from seconds to minutes. Strand separation, however, can be accomplished by any suitable denaturing method including physical, chemical, or enzymatic means. Strand separation may be induced by a helicase, for example, or an enzyme capable of exhibiting helicase activity. In addition to PCR and IVT reactions, the methods and devices of the present invention are also applicable to a number of other reaction types, e.g., reverse transcription, nick translation, and the like.

The nucleic acids in a sample will generally be labeled to facilitate detection in subsequent steps. Labeling may be carried out during the amplification, in vitro transcription or nick translation processes. In particular, amplification, in vitro transcription or nick translation may incorporate a label into the amplified or transcribed sequence, either through the use of labeled primers or the incorporation of labeled dNTPs into the amplified sequence.

Hybridization between the sample nucleic acid and the oligonucleotide probes on the array is then detected, using, e.g., epifluorescence confocal microscopy. Typically, the sample is mixed during hybridization to enhance hybridization of nucleic acids in the sample to nucleic acid probes on the array.

In some cases, hybridized oligonucleotides may be labeled following hybridization. For example, where biotin labeled dNTPs are used in, e.g. amplification or transcription, streptavidin linked reporter groups may be used to label hybridized complexes. Such operations are readily integrated into the systems of the present invention. Alternatively, the nucleic acids in the sample may be labeled following amplification. Post amplification labeling typically involves the covalent attachment of a particular detectable group to the amplified sequences. Suitable labels or detectable groups include a variety of fluorescent or radioactive labeling groups well known in the art, coupled to the sequences using methods that are well known in the art.

Methods for detection depend upon the label selected. A fluorescent label is preferred because of its extreme sensitivity and simplicity. Standard labeling procedures are used to determine the positions where interactions between a sequence and a reagent take place. For example, if a target sequence is labeled and exposed to a matrix of different probes, only those locations where probes interact with the target will exhibit any signal. Alternatively, other methods may be used to scan the matrix to determine where interaction takes place. Of course, the spectrum of interactions may be determined in a temporal manner by repeated scans of interactions which occur at each of a multiplicity of conditions. However, instead of testing each individual interaction separately, a multiplicity of sequence interactions may be simultaneously determined on a matrix.

Means of detecting labeled target (sample) nucleic acids hybridized to the probes of the high density array are known to those of skill in the art. Thus, for example, where a colorimetric label is used, the label is visualized. Where a radioactive labeled probe is used, detection of the radiation (e.g with photographic film or a solid state detector) is sufficient. In a preferred embodiment, the target nucleic acids are labeled with a fluorescent label and the localization of the label on the probe array is accomplished with fluorescent microscopy. The hybridized array is excited with a light source at the excitation wavelength of the particular fluorescent label and the resulting fluorescence at the emission wavelength is detected. In one preferred embodiment, the excitation light source is a laser appropriate for the excitation of the fluorescent label.

The target polynucleotide may be labeled by any of a number of convenient detectable markers. A fluorescent label is preferred because it provides a very strong signal with low background. It is also optically detectable at high resolution and sensitivity through a quick scanning procedure.

Other potential labeling moieties include, radioisotopes, chemiluminescent compounds, labeled binding proteins, heavy metal atoms, spectroscopic markers, magnetic labels, and linked enzymes.

Another method for labeling may bypass any label of the target sequence. The target may be exposed to the probes, and a double-stranded hybrid is formed at those positions only. Addition of a double-stranded specific reagent will detect where hybridization takes place. An intercalating dye such as ethidium bromide may be used as long as the probes do not fold back on themselves to a significant extent forming hairpin loops. However, the length of the hairpin loops in short oligonucleotide probes would typically be insufficient to form a stable duplex.

Suitable labels and chromogens will include molecules and compounds which absorb light in a distinctive range of wavelengths so that a color may be observed, or emit light when irradiated with radiation of a particular wave length or wave length range, e.g., fluorescers, biliproteins, e.g., phycoerythrin, may also serve as labels.

A wide variety of suitable dyes are available, including those chosen to provide an intense color with minimal absorption by their surroundings. Illustrative dye types include quinolone dyes, triarylmethane dyes, acridine dyes, alizarine dyes, phthaleins, insect dyes, azo dyes, anthraquinoid dyes, cyanine dyes, phenazathionium dyes, and phenazoxonium dyes. A wide variety of fluorescers may be employed either by themselves or in conjunction with quencher molecules. Fluorescers of interest fall into a variety of categories having certain primary functionalities, including 1- and 2-aminonaphthalene, p,p′-diaminostilbenes, pyrenes, quaternary phenanthridine salts, 9-aminoacridines, p,p′-diaminobenzophenone imines, anthracenes, oxacarbocyanine, merocyanine, 3-aminoequilenin, perylene, bis-benzoxazole, bis-p-oxazolyl benzene, 1,2-benzophenazin, retinol, bis-3-aminopyridinium salts, hellebrigenin, tetracycline, sterophenol, benzimidzaolylphenylamine, 2-oxo-3-chromen, indole, xanthen, 7-ydroxycoumarin, phenoxazine, salicylate, strophanthidin, porphyrins, triarylmethanes and flavin. Individual fluorescent compounds which have functionalities for linking or which can be modified to incorporate such functionalities include, e.g., dansyl chloride; fluoresceins such as 3,6-dihydroxy-9-phenylxanthhydrol; rhodamineisothiocyanate; N-phenyl 1-amino-8-sulfonatonaphthalene; N-phenyl 2-amino-6-sulfonatonaphthalene; 4-acetamido-4-10 isothiocyanato-stilbene-2,2′-disulfonic acid; pyrene-3-sulfonic acid; 2-toluidinonaphthalene-6-sulfonate; N-phenyl, N-methyl 2-aminoaphthalene-6-sulfonate; ethidium bromide; stebrine; Auromine 0,2-(9′-anthroyl) palmitate; dansyl phosphatidylethanolamine; N,N′-dioctadecyl oxacarbocyanine; N,N′-dihexyl oxacarbocyanine; merocyanine, 4-(3′ pyrenyl)butyrate; d-3-aminodesoxy-equilenin; 1,2-(9′-anthroyl)stearate; 2-methylanthracene; 9-vinylanthracene; 2,2′-(vinylene-p-phenylene)bisbenzoxazole; p-bis 2-(4-methyl-5-phenyl-oxazolyl)benzene; 6-dimethylamino-1,2-benzophenazin; retinol; bis(3′-aminopyridinium) 1,10-decandiyl diiodide; sulfonaphthylhydrazone of hellibrienin; chlorotetracycline; N-(7-dimethylamino-4-methyl-2-oxo-3-chromenyl)maleimide; N-p-(2-benzimidazolyl)-phenylmaleimide; N-(4-fluoranthyl) maleimide; bis(homovanillic acid); resazarin; 4-chloro-7-nitro-2,1,3-benzooxadiazole; merocyanine 540; resorufin; rose bengal; and 2,4-diphenyl-3(2H)furanone.

Desirably, fluorescers should absorb light above about 300 nm, preferably about 350 nm, and more preferably above about 400 nm, usually emitting at wavelengths greater than about 10 nm higher than the wavelength of the light absorbed. It should be noted that the absorption and emission characteristics of the bound dye may differ from the unbound dye. Therefore, when referring to the various wavelength ranges and characteristics of the dyes, it is intended to indicate this refers to the dyes as employed and not the dye which is unconjugated and characterized in an arbitrary solvent.

Fluorescers are generally preferred because by irradiating a fluorescer with light, one can obtain a plurality of emissions. Thus, a single label can provide for a plurality of measurable events. Detectable signal may also be provided by chemiluminescent and bioluminescent sources. Chemiluminescent sources include a compound which becomes electronically excited by a chemical reaction and may then emit light which serves as the detectable signal or donates energy to a fluorescent acceptor. A diverse number of families of compounds have been found to provide chemiluminescence under a variety of conditions. One family of compounds is 2,3-dihydro-1,-4-phthalazinedione. The most popular compound is luminol, which is the 5-amino compound. Other members of the family include the 5-amino-6,7,8-trimethoxy- and the dimethylamino)calbenz analog. These compounds can be made to luminesce with alkaline hydrogen peroxide or calcium hypochlorite and base. Another family of compounds is the 2,4,5-triphenylimidazoles, with lophine as the common name for the parent product. Chemiluminescent analogs include para-dimethylamino and -methoxy substituents. Chemiluminescence may also be obtained with oxalates, usually oxalyl active esters, e.g., p-nitrophenyl and a peroxide, e.g., hydrogen peroxide, under basic conditions. Alternatively, luciferins may be used in conjunction with luciferase or lucigenins to provide bioluminescence. Spin labels are provided by reporter molecules with an unpaired electron spin which can be detected by electron spin resonance (ESR) spectroscopy. Exemplary spin labels include organic free radicals, transitional metal complexes, particularly vanadium, copper, iron, and manganese, and the like. Exemplary spin labels include nitroxide free radicals. In addition, amplified sequences may be subjected to other post amplification treatments. For example, in some cases, it may be desirable to fragment the sequence prior to hybridization with an oligonucleotide array, in order to provide segments which are more readily accessible to the probes, and to avoid looping and/or hybridization to multiple probes. Fragmentation of the nucleic acids may generally be carried out by physical, chemical or enzymatic methods that are known in the art. Following the various sample preparation operations, the sample will generally be subjected to one or more analysis operations. Particularly preferred analysis operations include, e.g. sequence based analyses using an oligonucleotide array and/or size based analyses using, e.g. microcapillary array electrophoresis. In some embodiments it may be desirable to provide an additional or alternative means for analyzing the nucleic acids from the sample. Microcapillary array electrophoresis generally involves the use of a thin capillary or channel which may or may not be filled with a particular separation medium. Electrophoresis of a sample through the capillary provides a size based separation profile for the sample.

Microcapillary array electrophoresis generally provides a rapid method for size based sequencing, PCR product analysis and restriction fragment sizing. The high surface to volume ratio of these capillaries allows for the application of higher electric fields across the capillary without substantial thermal variation across the capillary, consequently allowing for more rapid separations. Furthermore, when combined with confocal imaging methods these methods provide sensitivity in the range of attomoles, which is comparable to the sensitivity of radioactive sequencing methods.

In many capillary electrophoresis methods, the capillaries which are formed, e.g. by fused silica capillaries or channels etched, machined or molded into planar substrates, are filled with an appropriate separation/sieving matrix. Typically, a variety of sieving matrices known in the art may be used in the microcapillary arrays. Examples of such matrices include, e.g. hydroxyethyl cellulose, polyacrylamide and agarose. Gel matrices may be introduced and polymerized within the capillary channel. However, in some cases this may result in entrapment of bubbles within the channels, which can interfere with sample separations. Accordingly, it is often desirable to place a preformed separation matrix within the capillary channel(s), prior to mating the planar elements of the capillary portion. Fixing the two parts, e.g. through sonic welding, permanently fixes the matrix within the channel. Polymerization outside of the channels helps to ensure that no bubbles are formed. Further, the pressure of the welding process helps to ensure a void-free system.

In addition to its use in nucleic acid “fingerprinting” and other sized-based analyses the capillary arrays may also be used in sequencing applications. In particular, gel based sequencing techniques may be readily adapted for capillary array electrophoresis. In addition to detection of mRNA or as the sole detection method, gene products from the markers discussed above may be detected as indicators of the biological condition of the tissue. Gene products may be detected in either the tissue sample as such, or in a body fluid sample, such as blood, serum, plasma, feces, mucus, sputum, cerebrospinal fluid, and/or urine of the individual. The expression products, peptides and proteins, may be detected by any suitable technique known to the person skilled in the art.

In a preferred embodiment the expression products are detected by means of specific antibodies directed to the various expression products, such as immunofluorescent and/or immunohistochemical staining of the tissue. Immunohistochemical localization of expressed proteins may be carried out by immunostaining of tissue sections from the single tumors to determine which cells expressed the protein encoded by the transcript in question. The transcript levels may be used to select a group of proteins supposed to show variation from sample to sample, making a rough correlation between the level of protein detected and the intensity of the transcript on the microarray possible. For example sections may be cut from paraffin-embedded tissue blocks, mounted, and deparaffinized by incubation at 80° C. for 10 minutes, followed by immersion in heated oil at 60° C. for 10 min. (Estisol 312, Estichem A/S, Denmark) and rehydration. Antigen retrieval is achieved in TEG (TrisEDTA-Glycerol) buffer using microwaves at 900 W. The tissue sections may be cooled in the buffer for 15 min before a brief rinse in tap water. Endogenous peroxidase activity is blocked by incubating the sections with 1% H₂0₂ for 20 min.; followed by three rinses in tap water, 1 min each. The sections may then be soaked in PBS buffer for 2 min. The next steps can be modified from the descriptions given by Oncogene Science Inc., in the Mouse Immunohistochemistry Detection System, XHC01 (UniTect, Uniondale, N.Y., USA). Briefly, the tissue sections are incubated overnight at 4° C. with primary antibody (against beta-2 microglobulin (Dako), cytokeratin 8, cystatin-C (both from Europa, US), junB, CD59, E-cadherin, apo-E, cathepsin E, vimentin, IGFII (all from Santa Cruz), followed by three rinses in PBS buffer for 5 min each. Afterwards, the sections are incubated with biotinylated secondary antibody for 30 min, rinsed three times with PBS buffer and subsequently incubated with ABC (avidin-biotinlylated horseradish peroxidase complex) for 30 min. followed by three rinses in PBS buffer.

Staining may be performed by incubation with AEC (3-amino-ethylcarbazole) for 10 min. The tissue sections are counter-stained with Mayers hematoxylin, washed in tap water for 5 min. and mounted with glycerol-gelatin. Positive and negative controls may be included in each staining round with all antibodies.

In yet another embodiment the expression products may be detected by means of conventional enzyme assays, such as ELISA methods. Furthermore, the expression products may be detected by means of peptide/protein chips capable of specifically binding the peptides and/or proteins assessed. Thereby an expression pattern may be obtained.

Assay

In a further aspect the invention relates to an assay for predicting the prognosis of a biological condition in animal tissue, comprising detecting an expression level of at least one gene selected from the group of genes consisting of gene Nos. 1 to 562, and more preferably, expression levels of one or more of the genes MBNL2, FABP4, UBE2C, and BIRC5, Preferably the assay further comprises means for correlating the expression level to at least one standard expression level and/or at least one reference pattern for a signature including two or more of the genes MBNL2, FABP4, UBE2C, and BIRC5. In another preferred embodiment, said signature further includes a second group, consisting of one or more of the genes COL18A1, COL4A1, ACTA2, MSN, KPNA2 and CDC25B.

The means for correlating preferably includes one or more expression levels and/or reference patterns or scores for use in comparing or correlating the expression levels or patterns obtained from a tumor under examination to a standard expression level. Preferably the invention relates to an assay for determining an expression pattern of a bladder cell, comprising at least a first marker and optionally another marker, wherein the first marker is a gene from a first gene group as defined above, and the other marker is a gene from the second gene group as defined above (COL18A1, COL4A1, ACTA2, MSN, KPNA2 and CDC25B), correlating the first expression level and/or the second expression level to a standard level of the assessed genes to predict the prognosis of a biological condition in the animal tissue.

As discussed above the marker may be detected with any nucleotide probe, such as a DNA, RNA, PNA, or LNA probe capable of hybridizing to mRNA or gene products indicative of the expression level. The hybridization conditions are preferably as described below for probes. In another embodiment the marker is detected with an antibody capable of specifically binding the expression product in question.

Patterns or scores can be compared manually by a person or by a computer. An algorithm can be used to detect similarities and differences. The algorithm may score and compare, for example, the genes which are expressed and the genes which are not expressed. Alternatively, the algorithm may look for changes in intensity of expression of a particular gene or marker and score changes in intensity between two samples. Similarities may be determined on the basis of genes which are expressed in both samples and genes which are not expressed in both samples or on the basis of genes whose intensities of expression are numerically similar.

Generally, the detection operation will be performed using a reader device external to the diagnostic device. However, it may be desirable in some cases to incorporate the data gathering operation into the diagnostic device itself. The detection apparatus may be a fluorescence detector, or a spectroscopic detector, or another detector.

Although hybridization is one type of specific interaction which is clearly useful for this mapping embodiment, antibody reagents may also be very useful. Gathering data from the various analysis operations, e.g. oligonucleotide and/or microcapillary arrays will typically be carried out using methods known in the art. For example, the arrays may be scanned using lasers to excite fluorescently labeled targets that have hybridized to regions of probe arrays mentioned above, which can then be imaged using charged coupled devices (“CCDs”) for a wide field scanning of the array. Alternatively, another particularly useful method for gathering data from the arrays is through the use of laser confocal microscopy which combines the ease and speed of a readily automated process with high resolution detection.

Following the data gathering operation, the data will typically be reported to a data analysis operation. To facilitate the sample analysis operation, the data obtained by the reader from the device will typically be analyzed using a digital computer. Typically, the computer will be appropriately programmed for receipt and storage of the data from the device, as well as for analysis and reporting of the data gathered, i.e., interpreting fluorescence data to determine the sequence of hybridizing probes, normalization of background and single base mismatch hybridizations, ordering of sequence data in SBH applications, and the like.

The invention also relates to a pharmaceutical composition for treating a biological condition, such as bladder tumors. In one embodiment the pharmaceutical composition comprises one or more of the peptides being expression products as defined above. In a preferred embodiment, the peptides are bound to carriers. The peptides may suitably be coupled to a polymer carrier, for example a protein carrier, such as BSA. Such formulations are well-known to the person skilled in the art.

The peptides may be suppressor peptides normally lost or decreased in tumor tissue administered in order to stabilize tumors towards a less malignant stage. In another embodiment the peptides are onco-peptides capable of eliciting an immune response towards the tumor cells. In another embodiment the pharmaceutical composition comprises genetic material, either genetic material for substitution therapy, or for suppressing therapy as discussed below. In a third embodiment the pharmaceutical composition comprises at least one antibody produced as described above.

In the present context the term pharmaceutical composition is used synonymously with the term medicament. The medicament of the invention comprises an effective amount of one or more of the compounds as defined above, or a composition as defined above in combination with pharmaceutically acceptable additives. Such medicament may suitably be formulated for oral, percutaneous, intramuscular, intravenous, intracranial, intrathecal, tracerebroventricular, intranasal or pulmonary administration. For most indications a localized or substantially localized application is preferred.

Strategies in formulation development of medicaments and compositions based on the compounds of the present invention generally correspond to formulation strategies for any other protein-based drug product. Potential problems and the guidance required to overcome these problems are addressed in several textbooks, e.g. “Therapeutic Peptides and Protein Formulation. Processing and Delivery Systems”, Ed. A. K. Banga, Technomic Publishing AG, Basel, 1995. Injectables are usually prepared either as liquid solutions or suspensions, solid forms suitable for solution in, or suspension in, liquid prior to injection. The preparation may also be emulsified. The active ingredient is often mixed with excipients which are pharmaceutically acceptable and compatible with the active ingredient. Suitable excipients are, for example, water, saline, dextrose, glycerol, ethanol or the like, and combinations thereof. In addition, if desired, the preparation may contain minor amounts of auxiliary substances such as wetting or emulsifying agents, pH buffering agents, or substances which enhance the effectiveness or transportation of the preparation.

Formulations of the compounds of the invention can be prepared by techniques known to the person skilled in the art. The formulations may contain pharmaceutically acceptable carriers and excipients including microspheres, liposomes, microcapsules and nanoparticles. The preparation may suitably be administered by injection, optionally at the site, where the active ingredient is to exert its effect. Additional formulations which are suitable for other modes of administration include suppositories, and in some cases, oral formulations. For suppositories, traditional binders and carriers include polyalkylene glycols or triglycerides. Such suppositories may be formed from mixtures containing the active ingredient(s) in the range of from 0.5% to 10%, preferably 1-2%. Oral formulations include such normally employed excipients as, for example, pharmaceutical grades of mannitol, lactose, starch, magnesium stearate, sodium saccharine, cellulose, magnesium carbonate, and the like. These compositions take the form of solutions, suspensions, tablets, pills, capsules, sustained release formulations or powders and generally contain 10-95% of the active ingredient(s), preferably 25-70%.

The preparations are administered in a manner compatible with the dosage formulation, and in such amount as will be therapeutically effective. The quantity to be administered depends on the subject to be treated, including, e.g. the weight and age of the subject, the disease to be treated and the stage of disease. Suitable dosage ranges are of the order of several hundred μg of active ingredient per administration with a preferred range of from about 0.1 μg to 1,000 μg, such as in the range of from about 1 μg to 300 μg, and especially in the range of from about 10 μg to 50 μg. Administration may be performed once or may be followed by subsequent administrations. The dosage will also depend on the route of administration and will vary with the age and weight of the subject to be treated. A preferred dosage would be at about 30 mg to 70 mg per 70 kg body weight.

Some of the compounds of the present invention are sufficiently active, but for some of the others, the effect will be enhanced if the preparation further comprises pharmaceutically acceptable additives and/or carriers. Such additives and carriers will be known in the art. In some cases, it will be advantageous to include a compound, which promotes delivery of the active substance to its target.

In many instances, it will be necessary to administrate the formulation multiple times. Administration may be a continuous infusion, such as intraventricular infusion or administration in more doses such as more times a day, daily, more times a week, weekly, etc.

Vaccines

In a further embodiment the present invention relates to a vaccine for the prophylaxis or treatment of a biological condition comprising at least one expression product from at least one gene, said gene being expressed as defined above.

The term vaccines is used with its normal meaning, i.e preparations of immunogenic material for administration to induce in the recipient an immunity to infection or intoxication by a given infecting agent. Vaccines may be administered by intravenous injection or through oral, nasal and/or mucosal administration. Vaccines may be either simple vaccines prepared from one species of expression products, such as proteins or peptides, or a variety of expression products, or they may be mixed vaccines containing two or more simple vaccines. They are prepared in such a manner as not to destroy the immunogenic material, although the methods of preparation vary, depending on the vaccine.

The enhanced immune response achieved according to the invention can be attributable to e.g. an enhanced increase in the level of immunoglobulins or in the level of T-cells including cytotoxic T-cells, which will result in immunization of a significant portion of individuals exposed to said immunogenic composition or vaccine.

Compositions according to the invention may also comprise any carrier and/or adjuvant known in the art including functional equivalents thereof. Functionally equivalent carriers are capable of presenting the same immunogenic determinant in essentially the same steric conformation when used under similar conditions. Functionally equivalent adjuvants are capable of providing similar increases in the efficacy of the composition when used under similar conditions.

Therapy

The invention further relates to a method of treating individuals suffering from the biological condition in question, in particular for treating a bladder tumor. Accordingly, the invention relates to a method for reducing cell tumorigenicity or malignancy of a cell, said method comprising contacting a tumor cell with at least one peptide expressed by at least one gene selected from the group of genes consisting of gene No. 200-214, 233, 234, 235, 236, 244, 249, 251, 252, 255, 256, 259, 261, 262, 266, 268, 269, 273, 274, 275, 276, 277, 279, 280, 281, 282, 285, 286, 289, 293, 295 (MBNL2), 296, 299, 301, 304, 306, 307, 308, 311, 312, 313, 314, 320, 322, 323, 325, 326, 327, 328, 330, 331, 332, 333, 334, 338, 341, 342, 343, 345, 348, 349, 350, 351, 352, 353, 355, 357, 360, 361, 363, 366, 367, 370, 373, 374, 375, 376, 385, 386, 387, 389, 390, 392, 394, 398, 400, 401, 405, 406, 407, 408, 410, 411, 412, 414, 415, 416, 418, 424, 426, 428, 433, 434, 435, 436, 438, 439, 440, 441, 442, 443, 445, 446, 453, 460, 461, 463, 464, 465, 466, 467 (FABP4), 469, 470, 471, 472, 473, 475, 476, 477, 479, 480, 481, 482, 483, 485, 486, 487, 488, 490, 492, 494, 496, 497, 498, 499, 503, 515, 516, 517, 521, 526, 527, 528, 530, 532, 533, 537, 539, 540, 541, 542, 543, 545, 554, 557, 560. In order to increase the effect, several different peptides may be used simultaneously, such as wherein the tumor cell is contacted with at least two different peptides.

In one embodiment the invention relates to a method of substitution therapy, i.e., administration of genetic material generally expressed in normal cells, but lost or decreased in biological condition cells (tumor suppressors). Thus, the invention relates to a method for reducing cell tumorigenicity or malignancy of a cell, said method comprising obtaining at least one gene selected from the group of genes consisting of gene No. 200-214, 233, 234, 235, 236, 244, 249, 251, 252, 255, 256, 259, 261, 262, 266, 268, 269, 273, 274, 275, 276, 277, 279, 280, 281, 282, 285, 286, 289, 293, 295 (MBNL2), 296, 299, 301, 304, 306, 307, 308, 311, 312, 313, 314, 320, 322, 323, 325, 326, 327, 328, 330, 331, 332, 333, 334, 338, 341, 342, 343, 345, 348, 349, 350, 351, 352, 353, 355, 357, 360, 361, 363, 366, 367, 370, 373, 374, 375, 376, 385, 386, 387, 389, 390, 392, 394, 398, 400, 401, 405, 406, 407, 408, 410, 411, 412, 414, 415, 416, 418, 424, 426, 428, 433, 434, 435, 436, 438, 439, 440, 441, 442, 443, 445, 446, 453, 460, 461, 463, 464, 465, 466, 467, 469, 470, 471, 472, 473, 475, 476 (FABP4), 477, 479, 480, 481, 482, 483, 485, 486, 487, 488, 490, 492, 494, 496, 497, 498, 499, 503, 515, 516, 517, 521, 526, 527, 528, 530, 532, 533, 537, 539, 540, 541, 542, 543, 545, 554, 557, 560, introducing said at least one gene into the tumor cell in a manner allowing expression of said gene(s).

In one embodiment at least one gene is introduced into the tumor cell. In another embodiment at least two genes are introduced into the tumor cell. In one aspect of the invention, small molecules that either inhibit increased gene expression or their effects or substitute decreased gene expression or their effects, are introduced to the cellular environment or the cells. Application of small molecules to tumor cells may be performed by e.g. local application or intravenous injection or by oral ingestion. Small molecules have the ability to restore function of reduced gene expression in tumor or cancer tissue.

In another aspect the invention relates to a therapy whereby genes (increase and/or decrease) which generally are correlated to disease are inhibited by one or more of the following methods: A method for reducing cell tumorigenicity or malignancy of a cell, said method comprising obtaining at least one nucleotide probe capable of hybridizing with at least one gene of a tumor cell, said at least one gene being selected from the group of genes consisting of gene Nos. 1-199, 215-232, 237, 238, 239, 240, 241, 242, 243, 245, 246, 247, 248, 250, 253, 254, 257, 258, 260, 263, 264, 265, 267, 270, 271, 272, 278, 283, 284, 287, 288, 290, 291, 292, 294, 297, 298, 300, 302, 303, 305, 309, 310, 315, 316, 317, 318, 319, 321, 324, 329, 335, 336, 337, 339, 340, 344, 346, 347, 354, 356, 358, 359, 362, 364, 365, 368, 369, 371, 372, 377, 378, 379, 380, 381, 382, 383, 384, 388, 391, 393, 395, 396, 397, 399, 402, 403, 404, 409, 413, 417, 419, 420, 421, 422, 423, 425, 427, 429, 430, 431, 432, 437 (BIRC5), 444, 447, 448, 449, 450, 451, 452, 454, 455, 456, 457, 458, 459, 462, 468, 474, 478, 484, 489, 491, 493, 495, 500, 501, 502, 504, 505, 506, 507, 508, 509, 510, 511, 512, 513, 514, 518, 519, 520, 522, 523, 524, 525, 529, 531, 534, 535, 536, 538, 544, 546, 547, 548, 549, 550, 551, 552, 553, 555, 556, 558, 559, 561, 562, introducing said at least one nucleotide probe into the tumor cell in a manner allowing the probe to hybridize to the at least one gene, thereby inhibiting expression of said at least one gene. This method is preferably based on anti-sense technology, whereby the hybridization of said probe to the gene leads to a down-regulation of said gene.

In another preferred embodiment, the method for reducing cell tumorigenicity or malignancy of a cell is based on RNA interference, comprising small interfering RNAs (siRNAs) specifically directed against at least one gene being selected from the group of genes consisting of gene Nos. 1-199, 215-232, 237, 238, 239, 240, 241, 242, 243, 245, 246, 247, 248, 250, 253, 254, 257, 258, 260, 263, 264, 265, 267, 270, 271, 272, 278, 283, 284, 287, 288, 290, 291, 292, 294, 297, 298, 300, 302, 303, 305, 309, 310, 315, 316, 317, 318, 319, 321, 324, 329, 335, 336, 337, 339, 340, 344, 346, 347, 354, 356, 358, 359, 362, 364, 365, 368, 369, 371, 372, 377, 378, 379, 380, 381, 382, 383, 384, 388, 391, 393, 395, 396, 397, 399, 402, 403, 404, 409, 413, 417, 419, 420, 421, 422, 423, 425, 427, 429, 430, 431, 432, 437 (BIRC5), 444, 447, 448, 449, 450, 451, 452, 454, 455, 456, 457, 458, 459, 462, 468, 474, 478, 484, 489, 491, 493, 495, 500, 501, 502, 504, 505, 506, 507, 508, 509, 510, 511, 512, 513, 514, 518, 519, 520, 522, 523, 524, 525, 529, 531, 534, 535, 536, 538, 544, 546, 547, 548, 549, 550, 551, 552, 553, 555, 556, 558, 559, 561, 562.

The down-regulation may of course also be based on a probe capable of hybridizing to regulatory components of the genes in question, such as promoters. The hybridization may be tested in vitro under conditions corresponding to in vivo conditions. Typically, hybridization conditions are of low to moderate stringency. These conditions favor specific interactions between completely complementary sequences, but allow some non-specific interaction between less than perfectly matched sequences to occur as well. After hybridization, the nucleic acids can be “washed” under moderate or high conditions of stringency to dissociate duplexes that are bound together by some non-specific interaction (the nucleic acids that form these duplexes are thus not completely complementary).

As is known in the art, the optimal conditions for washing are determined empirically, often by gradually increasing the stringency. The parameters that can be changed to affect stringency include, primarily, temperature and salt concentration. In general, the lower the salt concentration and the higher the temperature, the higher the stringency. Washing can be initiated at a low temperature (for example, room temperature) using a solution containing a salt concentration that is equivalent to or lower than that of the hybridization solution. Subsequent washing can be carried out using progressively warmer solutions having the same salt concentration. As alternatives, the salt concentration can be lowered and the temperature maintained in the washing step, or the salt concentration can be lowered and the temperature increased. Additional parameters can also be altered. For example, use of a destabilizing agent, such as formamide, alters the stringency conditions.

In reactions where nucleic acids are hybridized, the conditions used to achieve a given level of stringency will vary. There is not one set of conditions, for example, that will allow duplexes to form between all nucleic acids that are 85% identical to one another; hybridization also depends on unique features of each nucleic acid. The length of the sequence, the composition of the sequence (for example, the content of purine-like nucleotides versus the content of pyrimidine-like nucleotides) and the type of nucleic acid (for example, DNA or RNA) affect hybridization. An additional consideration is whether one of the nucleic acids is immobilized (for example on a filter).

An example of a progression from lower to higher stringency conditions is the following: where the salt content is given as the relative abundance of SSG (a salt solution containing sodium chloride and sodium citrate; 2×SSG is 10-fold more concentrated than 0.2×SSG). Nucleic acids are hybridized at 42″C in 2×SSG/0.1% SOS (sodium dodecylsulfate; a detergent) and then washed in 0.2×SSG/0.1% SOS at room temperature (for conditions of low stringency); 0.2×SSG/0.1% SOS at 42° C. (for conditions of moderate stringency); and 0.1×SSG at 68° C. (for conditions of high stringency). Washing can be carried out using only one of the conditions given, or each of the conditions can be used (for example, washing for 10-15 minutes each in the order listed above). Any or all of the washes can be repeated. As mentioned above, optimal conditions will vary and can be determined empirically.

In another aspect a method of reducing tumoregeneicity relates to the use of antibodies against an expression product of a cell from the biological tissue. The antibodies may be produced by any suitable method, such as a method comprising the steps of obtaining expression product(s) from at least one gene said gene being expressed as defined above, immunizing a mammal with said expression product(s) and obtaining antibodies against the expression product.

The methods described above may be used for producing an assay for diagnosing a biological condition in animal tissue, or for identification of the origin of a piece of tissue. Further, the methods of the invention may be used for prediction of a disease course and treatment response. Furthermore, the invention relates to the use of a peptide as defined above for preparation of a pharmaceutical composition for the treatment of a biological condition in animal tissue. Furthermore, the invention relates to the use of a gene as defined above for preparation of a pharmaceutical composition for the treatment of a biological condition in animal tissue.

Also, the invention relates to the use of a probe as defined above for preparation of a pharmaceutical composition for the treatment of a biological condition in animal tissue. The genetic material discussed above may be any of the described genes or functional parts thereof. The constructs may be introduced as a single DNA molecule encoding all of the genes, or different DNA molecules having one or more genes. The constructs may be introduced simultaneously or consecutively, each with the same or different markers. The gene may be linked to the complex as such or protected by any suitable system normally used for transfection, such as viral vectors or artificial viral envelope, liposomes or micelles, wherein the system is linked to the complex.

Numerous techniques for introducing DNA into eukaryotic cells are known to the skilled artisan. Often this is done by means, of vectors, and often in the form of nucleic acid encapsulated by a (frequently virus-like) proteinaceous coat. Gene delivery systems may be applied to a wide range of clinical as well as experimental applications.

Vectors containing useful elements such as selectable and/or amplifiable markers, promoter/enhancer elements for expression in mammalian, particularly human, cells, and which may be used to prepare stocks of construct DNAs and for carrying out transfections are well known in the art. Many are commercially available.

Various techniques have been developed for modification of target tissue and cells in vivo. A number of virus vectors, discussed below, are known which allow transfection and random integration of the virus into the host. See, for example, Dubensky et al. (1984) Proc. Natl. Acad. Sci. USA 81:7529-7533; Kaneda et al., (1989) Science 243:375-378; Hiebert et al. (1989) Proc. Natl. Acad. Sci. USA 86:3594-3598; Hatzoglu et al., (1990) J. Biol. Chem. 265:17285-17293; Ferry et al. (1991) Proc. Natl. Acad. Sci. USA 88:8377-8381. Routes and modes of administering the vector include injection, e.g intravascularly or intramuscularly, inhalation, or other parenteral administration.

Advantages of adenovirus vectors for human gene therapy include the fact that recombination is rare, no human malignancies are known to be associated with such viruses, the adenovirus genome is double stranded DNA which can be manipulated to accept foreign genes of up to 7.5 kb in size, and live adenovirus is a safe human vaccine organism. Another vector which can express the DNA molecule of the present invention, and is useful in gene therapy, particularly in humans, is vaccinia virus, which can be rendered nonreplicating (U.S. Pat. Nos. 5,225,336; 5,204,243; 5,155,020; 4,769,330).

Based on the concept of viral mimicry, artificial viral envelopes (AVE) are designed based on the structure and composition of a viral membrane, such as HIV-1 or RSV and used to deliver genes into cells in vitro and in vivo. See, for example, U.S. Pat. No. 5,252,348, Schreier H. et al., J. Mol. Recognit., 1995, 8:59-62; Schreier H et al., J. Biol. Chem., 1994, 269:9090-9098; Schreier, H., Pharm. Acta Helv. 1994, 68:145-159; Chander, R et al. Life Sci., 1992, 30 50:481-489, which references are hereby incorporated by reference in their entirety. The envelope is preferably produced in a two-step dialysis procedure where the “naked” envelope is formed initially, followed by unidirectional insertion of the viral surface glycoprotein of interest. This process and the physical characteristics of the resulting AVE are described in detail by Chander et al., (supra). Examples of AVE systems are (a) an AVE containing the HIV-1 surface glycoprotein gp160 (Chander et al., supra; Schreier et al., 1995, supra) or glycosyl phosphatidylinositol (GPI)-linked gp120 (Schreier et al., 1994, supra), respectively, and (b) an AVE containing the respiratory syncytial virus (RSV) attachment (G) and fusion (F) glycoproteins (Stecenko, A. A. et al., Pharm. Pharmacol. Lett. 1:127-129 (1992)). Thus, vesicles are constructed which mimic the natural membranes of enveloped viruses in their ability to bind to and deliver materials to cells bearing corresponding surface receptors. AVEs are used to deliver genes both by intravenous injection and by instillation in the lungs.

For example, AVEs are manufactured to mimic RSV, exhibiting the RSV F surface glycoprotein which provides selective entry into epithelial cells. F-AVE are loaded with a plasmid coding for the gene of interest (or a reporter gene such as CAT not present in mammalian tissue). The AVE system described herein in physically and chemically essentially identical to the natural virus yet is entirely “artificial”, as it is constructed from phospholipids, cholesterol, and recombinant viral surface glycoproteins. Hence, there is no carry-over of viral genetic information and no danger of inadvertent viral infection. Construction of the AVEs in two independent steps allows for bulk production of the plain lipid envelopes which, in a separate second step, can then be marked with the desired viral glycoprotein, also allowing for the preparation of protein cocktail formulations if desired.

Another delivery vehicle for use in the present invention is based on the recent description of attenuated Shigella as a DNA delivery system (Sizemore, D. R. et al., Science 270:299-20 302 (1995), which reference is incorporated by reference in its entirety). This approach exploits the ability of Shigellae to enter epithelial cells and escape the phagocytic vacuole as a method for delivering the gene construct into the cytoplasm of the target cell. Invasion with as few as one to five bacteria can result in expression of the foreign plasmid DNA delivered by these bacteria.

A preferred type of mediator of nonviral transfection in vitro and in vivo is cationic (ammonium derivatized) lipids. These positively charged lipids form complexes with negatively charged DNA, resulting in DNA charged neutralization and compaction. The complexes are endocytosed upon association with the cell membrane, and the DNA somehow escapes the endosome, gaining access to the cytoplasm. Cationic lipid:DNA complexes appear highly stable under normal conditions. Studies of the cationic lipid DOTAP suggest the complex dissociates when the inner layer of the cell membrane is destabilized and anionic lipids from the inner layer displace DNA from the cationic lipid. Several cationic lipids are available commercially. Two of these, DMRI and DC-cholesterol, have been used in human clinical trials. First generation cationic lipids are less efficient than viral vectors. For delivery to lung, any inflammatory responses accompanying the liposome administration are reduced by changing the delivery mode to aerosol administration, which distributes the dose more evenly.

Drug Screening

Genes identified as changing in various stages of bladder cancer can be used as markers for drug screening. Thus, by treating bladder cancer cells with test compounds or extracts, and monitoring the expression of genes identified as changing in the progression of bladder cancers, one can identify compounds or extracts which change expression of genes to a pattern which is of an earlier stage or even of normal bladder mucosa. It is also within the scope of the invention to use small molecules in drug screening.

The following are non-limiting examples illustrating the present invention.

EXAMPLES Example 1

Identification of a molecular signature defining disease progression in patients with superficial bladder carcinoma.

Patient Samples

Bladder tumor biopsies were obtained directly from surgery after removal of the necessary amount of tissue for routine pathology examination. The tumors were frozen at −80° C. in a guanidinium thiocyanate solution for preservation of the RNA. Informed consent was obtained in all cases, and the protocols were approved by the scientific ethical committee of Aarhus County. The samples for the no progression group were selected by the following criteria: a) Ta or T1 tumors with no prior higher stage tumors; b) a minimum follow up period of 12 months to the most recent routine cystoscopy examination of the bladder with no occurrence of tumors of higher stage. The samples for the progression group were selected by two criteria: a) Ta or T1 tumors with no prior higher stage tumors; b) subsequent progression to a higher stage tumor, see Table 1.

TABLE 1 Clinical data on all patients involved in the study Follow-up Time to time Group Sample Hist. Progressed to: progression months Training set No prog. 150-6 Ta gr3 — — 44 No prog. 997-1 Ta gr2 — — 24 No prog. 833-2 Ta gr3 — — 35 No prog. 1070-1 Ta gr3 — — 33 No prog. 968-1 Ta gr2 — — 26 No prog. 625-1 T1 gr3 — — 12 No prog. 880-1 T1 gr3 — — 47 No prog. 815-1 Ta gr2 — — 49 No prog. 861-1 Ta gr2 — — 45 No prog. 669-1 Ta gr2 — — 55 No prog. 368-4 Ta gr2 — — 16 No prog. 898-1 Ta gr2 — — 17 No prog. 576-6 Ta gr2 — — 36 Prog. 747-3 Ta gr2 T1 gr3 6 Prog. 956-2 Ta gr3 T1 gr3 27 — Prog. 1083-1 Ta gr2 T1 gr3 1 — Prog. 686-3 Ta gr2 T1 gr2 6 — Prog. 795-13 Ta gr2 T1 gr3 4 — Prog. 865-1 Ta gr2 T1 gr2 5 — Prog. 112-2 Ta gr3 T1 gr3 7 — Prog. 825-3 Ta gr3 T1 gr3 6 — Prog. 679-2 Ta gr2 T2+ gr3 31 — Prog. 941-4 Ta gr3 T2+ gr3 10 — Prog. 607-1 T1 gr2 T2+ gr3 3 — Prog. 1017-1 T1 gr3 T2+ gr3 8 — Prog. 1276-1 T1 gr3 T2+ gr3 7 — Prog. 501-1 T1 gr3 T2+ gr3 26 — Prog. 744-1 T1 gr3 T2+ gr3 14 — Prog. 839-1 T1 gr3 T2+ gr3 12 — Test set No prog. 1008-1 Ta gr2 — — 55 No prog. 1060-1 Ta gr2 — — 48 No prog. 1086-1 Ta gr2 — — 34 No prog. 1105-1 Ta gr2 — — 31 No prog. 1145-1 Ta gr2 — — 39 No prog. 1352-1 Ta gr2 — — 26 No prog. 829-1 Ta gr2 — — 37 No prog. 942-1 Ta gr2 — — 37 No prog. 780-1 Ta gr2 — — 50 Prog 1327-1 Ta gr2 T1 gr3 8 Prog. 1062-2 Ta gr3 T1 gr3 4 — Prog. 1354-1 Ta gr3 T1 gr3 8 — Prog. 1093-1 Ta gr3 T1 gr3 5 — Prog. 925-7 Ta gr2 T1 gr3 4 — Prog. 962-10 Ta gr0 T2+ gr3 1 — Prog. 970-1 Ta gr3 T2+ gr3 1 — Prog. 1027-1 Ta gr3 T2+ gr3 2 — Prog. 1252-1 T1 gr3 T2+ gr3 5 — Prog. 1191-1 T1 gr4 T2+ gr4 1 — Delineation of Non-Progressing Tumors from Progressing Tumors

To delineate non-progressing tumors from progressing tumors we now profiled a total of 29 bladder tumor samples; 13 early stage bladder tumor samples without progression (median follow-up time 35 months) and 16 early stage bladder tumor samples with progression (median time to progression 7 months). See Table 1 for description of patient disease courses. We analyzed gene expression changes between the two groups of tumors by hybridizing the labeled RNA samples to customized Affymetrix GeneChips with 59,000 probe-sets to cover virtually the entire transcriptome (˜95% coverage). Low expressed and non-varying probe-sets were eliminated from the data set and the resulting 6,647 probe-sets that showed variation across the tumor samples were subjected to further analysis. These probe-sets represent 5,356 unique genes (Unigene clusters).

Gene Expression Similarities Between Tumor Biopsies

We analyzed gene expression similarities between the tumor biopsies using unsupervised hierarchical cluster analysis (FIG. 1). This showed a notable distinction between the non-progressing and the progressing tumors when using the 3,197 most varying probe-sets (s.d.≧75) for clustering (4 errors; χ² test, P=0.0001). Using other gene-sets based on different gene variation criteria demonstrated the same distinction between the tumor groups. Two of the samples that show later progression (825-3 and 112-2) were found in the non-progression branch of the cluster dendrogram and two of the non-progressing samples (815-1 and 150-6) were found in the progression branch. This distinct separation of the samples indicated a considerable biological difference between the two groups of tumors. Notably, the T1 tumors did not cluster separately from Ta tumors; however, they did form a sub-cluster in the progressing branch of the dendrogram. Based on this we decided to look for a general signature of progression disregarding pathologic staging of the tumors.

Selection of the 100 Most Significantly Up-Regulated Genes in Each Group Using t-Test Statistics

We delineated the non-progressing tumors from the progressing tumors by selecting the 100 most significantly up-regulated genes in each group using t-test statistics (Table 2). Among the genes up regulated in the non-progressing group we found the SERPINB5 and FAT tumor suppressor genes and the FGFR3 gene, which has been shown to be frequently mutated in superficial bladder tumors with low recurrence rates (van Rhijn et al. 2001). Among the genes up regulated in the progressing group we found the PLK (Yuan et al. 1997), CDC25B (Galaktionov et al. 1991), CDC20 (Weinstein et al. 1994) and MCM7 (Hiraiwa et al. 1997) genes, which are involved in regulating cell cycle and cell proliferation. Furthermore, in this group we identified the WHSC1, DD96 and GRB7 genes, which have been predicted/computed (Gene Ontology) to be involved in oncogenic transformation. Another interesting candidate in this group is the NRG1 gene, which through interaction with the HER2/HER3 receptors has been found to induce differentiation of lung epithelial cells (Liu & Kern 2002). The PPARD gene was also identified as up regulated in the tumors that show later progression. Disruption of this gene was found to decrease tumorigenicity in colon cancer cells (Park et al. 2001). Furthermore, PPARD regulates VEGF expression in bladder cancer cell lines (Fauconnet et al. 2002).

TABLE 2 The 200 best markers of progression Eos Unigene Hu03 Build T- 5% Exemplar ID 133 Description test perm accession# 416640 Hs.79404 neuron-specific protein 6.03 5.62 BE262478 442220 Hs.8148 selenoprotein T 5.98 5.06 AL037800 426982 Hs.173091 ubiquitin-like 3 5.9 4.88 AA149707 416815 Hs.80120 UDP-N-acetyl-alpha-D-galactosamine:polypeptide N- 5.52 4.67 U41514 acetylgalactosaminyltransferase 1 (GalNAc-T1) 435521 Hs.6361 mitogen-activated protein kinase kinase 1 interacting 5.24 4.51 W23814 protein 1 447343 Hs.236894 ESTs, Highly similar to S02392 alpha-2-macroglobulin 5.23 4.44 AA256641 receptor precursor [H. sapiens] 452829 Hs.63368 ESTs, Weakly similar to TRHY_HUMAN 4.95 4.39 AI955579 TRICHOHYALI [H. sapiens] 414895 Hs.116278 Homo sapiens cDNA FLJ13571 fis, clone 4.94 4.31 AW894856 PLACE1008405 426252 Hs.28917 ESTs 4.9 4.26 BE176980 444604 Hs.11441 chromosome 1 open reading frame 8 4.89 4.17 AW327695 409632 Hs.55279 serine (or cysteine) proteinase inhibitor, clade B 4.89 4.13 W74001 (ovalbumin), member 5 446556 Hs.15303 KIAA0349 protein 4.87 4.08 AB002347 426799 Hs.303154 popeye protein 3 4.86 4.03 H14843 428115 Hs.300855 KIAA0977 protein 4.86 4.00 AB023194 419847 Hs.184544 Homo sapiens, clone IMAGE: 3355383, mRNA, partial 4.82 3.97 AW390601 cds 417839 Hs.82712 fragile X mental retardation, autosomal homolog 1 4.8 3.93 AI815732 428284 Hs.183435 NM_004545: Homo sapiens NADH dehydrogenase 4.78 3.92 AA535762 (ubiquinone) 1 beta subcomplex, 1 (7 kD, MNLL) (NDUFB1), mRNA. 422929 Hs.94011 ESTs, Weakly similar to MGB4_HUMAN 4.77 3.90 AA356694 MELANOMA-ASSOCIATED ANTIGEN B4 [H. sapiens] 414762 Hs.77257 KIAA0068 protein 4.72 3.86 AW068349 453395 Hs.377915 mannosidase, alpha, class 2A, member 1 4.71 3.84 D63998 421311 Hs.283609 hypothetical protein PRO2032 4.65 3.82 N71848 446847 Hs.82845 Homo sapiens cDNA: FLJ21930 fis. clone HEP04301, 4.65 3.82 T51454 highly similar to HSU90916 Human clone 23815 mRNA sequence 413840 Hs.356228 RNA binding motif protein, X chromosome 4.62 3.79 AI301558 418321 Hs.84087 KIAA0143 protein 4.62 3.78 D63477 430604 Hs.247309 succinate-CoA ligase, GDP-forming, beta subunit 4.61 3.74 AV650537 423185 Hs.380062 ornithine decarboxylase antizyme 1 4.61 3.74 BE299590 417615 Hs.82314 hypoxanthine phosphoribosyltransferase 1 (Lesch- 4.6 3.70 BE548641 Nyhan syndrome) 418504 Hs.85335 Homo sapiens mRNA; cDNA DKFZp564D1462 (from 4.59 3.68 BE159718 clone DKFZp564D1462) 400846 — sortilin-related receptor, L(DLR class) A repeats- 4.57 3.66 — containing (SORL1) 426028 Hs.172028 a disintegrin and metalloproteinase domain 10 4.53 3.65 NM_001110 (ADAM10) 425243 Hs.155291 KIAA0005 gene product 4.47 3.63 N89487 434978 Hs.4310 eukaryotic translation initiation factor 1A 4.45 3.62 AA321238 409513 Hs.54642 methionine adenosyltransferase II, beta 4.43 3.59 AW966728 433282 Hs.49007 hypothetical protein 4.43 3.56 BE539101 421628 Hs.106210 hypothetical protein FLJ10813 4.37 3.56 AL121317 452170 Hs.28285 patched related protein translocated in renal cancer 4.37 3.54 AF064801 440014 Hs.6856 ash2 (absent, small, or homeotic, Drosophila, 4.37 3.52 AW960782 homolog)-like 431857 Hs.271742 ADP-ribosyltransferase (NAD; poly (ADP-ribose) 4.36 3.52 W19144 polymerase)-like 3 417924 Hs.82932 cyclin D1 (PRAD1: parathyroid adenomatosis 1) 4.35 3.51 AU077231 421733 Hs.1420 fibroblast growth factor receptor 3 (achondroplasia, 4.34 3.50 AL119671 thanatophoric dwarfism) 440197 Hs.317714 pallid (mouse) homolog, pallidin 4.32 3.49 AW340708 434055 Hs.3726 x 003 protein 4.32 3.48 AF168712 445831 Hs.13351 LanC (bacterial lantibiotic synthetase component C)- 4.31 3.46 NM_006055 like 1 439632 Hs.334437 hypothetical protein MGC4248 4.29 3.45 AW410714 448813 Hs.22142 cytochrome b5 reductase b5R.2 4.28 3.44 AF169802 449268 Hs.23412 hypothetical protein FLJ20160 4.28 3.43 AW369278 429311 Hs.198998 conserved helix-loop-helix ubiquitous kinase 4.28 3.42 AF080157 423599 Hs.31731 peroxiredoxin 5 4.27 3.41 AI805664 422913 Hs.121599 CGI-18 protein 4.26 3.40 NM_015947 418127 Hs.83532 membrane cofactor protein (CD46, trophoblast- 4.26 3.39 BE243982 lymphocyte cross-reactive antigen) 425221 Hs.155188 TATA box binding protein (TBP)-associated factor, 4.25 3.38 AV649864 RNA polymerase II, F, 55 kD 426682 Hs.2056 UDP glycosyltransferase 1 family, polypeptide A9 4.23 3.37 AV660038 421101 Hs.101840 major histocompatibility complex, class I-like 4.23 3.37 AF010446 sequence 444037 Hs.380932 CHMP1.5 protein 4.22 3.35 AV647686 443407 Hs.348514 ESTs, Moderately similar to 2109260A B cell growth 4.21 3.35 AA037683 factor [H. sapiens] 448625 Hs.178470 hypothetical protein FLJ22662 4.21 3.34 AW970786 450997 Hs.35254 hypothetical protein FLB6421 4.16 3.34 AW580830 444336 Hs.10882 HMG-box containing protein 1 4.15 3.33 AF019214 416977 Hs.406103 hypothetical protein FKSG44 4.14 3.32 AW130242 420613 Hs.406637 ESTs, Weakly similar to A47582 B-cell growth factor 4.13 3.31 AI873871 precursor [H. sapiens] 414843 Hs.77492 heterogeneous nuclear ribonucleoprotein A0 4.1 3.30 BE386038 408288 Hs.16886 gb: zI73d06.r1 Stratagene colon (937204) Homo 4.09 3.29 AA053601 sapiens cDNA clone 5′, mRNA sequence 422043 Hs.110953 retinoic acid induced 1 4.09 3.29 AL133649 432864 Hs.359682 calpastatin 4.08 3.28 D16217 410047 Hs.379753 zinc finger protein 36 (KOX 18) 4.06 3.28 AI167810 400773 — NM_003105*: Homo sapiens sortilin-related receptor, 4.06 3.27 — L(DLR class) A repeats-containing (SORL1), mRNA. 423960 Hs.136309 SH3-containing protein SH3GLB1 4.05 3.27 AA164516 449626 Hs.112860 zinc finger protein 258 4.04 3.27 AA774247 429953 Hs.226581 COX15 (yeast) homolog, cytochrome c oxidase 4.04 3.24 NM_004376 assembly protein 428901 Hs.146668 KIAA1253 protein 4.02 3.24 AI929568 420079 Hs.94896 PTD011 protein 3.99 3.22 NM_014051 436576 Hs.77542 ESTs, Homo sapiens platelet-activating factor 3.98 3.21 AI458213 receptor (PTAFR) 412841 Hs.101395 hypothetical protein MGC11352 3.97 3.21 AI751157 431604 Hs.264190 vacuolar protein sorting 35 (yeast homolog) 3.96 3.21 AF175265 428318 Hs.356190 ubiquitin B 3.96 3.19 BE300110 430677 Hs.359784 desmoglein 2 3.95 3.19 Z26317 407955 Hs.9343 ESTs, RPTOR independent companion of MTOR, 3.94 3.18 BE536739 complex 2, RICTOR 426177 Hs.167700 Homo sapiens cDNA FLJ10174 fis, clone 3.92 3.17 AA373452 HEMBA1003959 429802 Hs.5367 ESTs, Weakly similar to I38022 hypothetical protein 3.92 3.17 H09548 [H. sapiens] 423810 Hs.132955 BCL2/adenovirus E1B 19 kD-interacting protein 3-like 3.92 3.16 AL132665 421475 Hs.104640 HIV-1 inducer of short transcripts binding protein; 3.91 3.15 AF000561 lymphoma related factor 436472 Hs.46366 KIAA0948 protein 3.91 3.14 AL045404 434263 Hs.79187 ESTs, coxsackie virus and adenovirus receptor, 3.9 3.13 N34895 CXADR 400843 — NM_003105*: Homo sapiens sortilin-related receptor, 3.9 3.13 — L(DLR class) A repeats-containing (SORL1), mRNA. 440357 Hs.20950 phospholysine phosphohistidine inorganic 3.89 3.12 AA379353 pyrophosphate phosphatase 437223 Hs.330716 Homo sapiens cDNA FLJ14368 fis, clone 3.88 3.12 C15105 HEMBA1001122 426125 Hs.166994 FAT tumor suppressor (Drosophila) homolog 3.86 3.11 X87241 432554 Hs.278411 NCK-associated protein 1 3.86 3.10 AI479813 422506 Hs.300741 sorcin 3.85 3.10 R20909 413786 Hs.13500 ESTs, Homo sapiens major histocompatibility 3.83 3.09 AW613780 complex, class I-related, MR1 429561 Hs.250646 baculoviral IAP repeat-containing 6 3.83 3.08 AF265555 404977 — Insulin-like growth factor 2 (somatomedin A) (IGF2) 3.83 3.08 — 427722 Hs.180479 hypothetical protein FLJ20116 3.82 3.08 AK000123 400844 — NM_003105*: Homo sapiens sortilin-related receptor, 3.82 3.08 — L(DLR class) A repeats-containing (SORL1), mRNA. 426469 Hs.363039 methylmalonate-semialdehyde dehydrogenase 3.81 3.07 BE297886 439578 Hs.350547 nuclear receptor co-repressor/HDAC3 complex 3.81 3.06 AW263124 subunit 426508 Hs.170171 glutamate-ammonia ligase (glutamine synthase) 3.8 3.06 W23184 448524 Hs.21356 hypothetical protein DKFZp762K2015 3.79 3.06 AB032948 448357 Hs.108923 RAB38, member RAS oncogene family 3.79 3.06 N20169 425097 Hs.154545 PDZ domain containing guanine nucleotide exchange 3.77 3.05 NM_014247 factor(GEF)1 421649 Hs.106415 peroxisome proliferative activated receptor, delta 5.76 5.50 AA721217 427747 Hs.180655 serine/threonine kinase 12 5.41 5.03 AW411425 439010 Hs.75216 Homo sapiens cDNA FLJ13713 fis, clone 4.57 4.80 AW170332 PLACE2000398, moderately similar to LAR PROTEIN PRECURSOR (LEUKOCYTE ANTIGEN RELATED) (EC 3.1.3.48) 438818 Hs.30738 ESTs 4.49 4.59 AW979008 438013 Hs.15670 ESTs, transcribed locus from chromosome 16 4.42 4.50 AI002106 452929 Hs.172816 neuregulin 1 4.37 4.40 AW954938 404826 — Target Exon 4.22 4.32 — 429124 Hs.196914 minor histocompatibility antigen HA-1 4.2 4.26 AW505086 421505 Hs.285641 KIAA1111 protein 4.16 4.24 AW249934 428712 Hs.190452 KIAA0365 gene product 4.14 4.19 AW085131 427239 Hs.356512 ubiquitin carrier protein 4.11 4.10 BE270447 421595 Hs.301685 KIAA0620 protein 4.1 4.07 AB014520 433844 Hs.179647 Homo sapiens cDNA FLJ12195 fis, clone 4.04 4.02 AA610175 MAMMA1000865 443679 Hs.9670 hypothetical protein FLJ10948 4.01 4.00 AK001810 422959 Hs.349256 paired immunoglobulin-like receptor beta 4.01 3.98 AV647015 452012 Hs.279766 kinesin family member 4A 3.98 3.96 AA307703 435320 Hs.117864 ESTs 3.97 3.91 AA677934 456332 Hs.399939 gb: nc39d05.r1 NCI_CGAP_Pr2 Homo sapiens cDNA 3.95 3.88 AA228357 clone, mRNA sequence 427999 Hs.181369 ubiquitin fusion degradation 1-like 3.94 3.86 AI435128 427681 Hs.284232 tumor necrosis factor receptor superfamily, member 3.93 3.81 AB018263 12 (translocating chain-association membrane protein) 413929 Hs.75617 collagen, type IV, alpha 2 3.93 3.79 BE501689 420116 Hs.95231 FH1/FH2 domain-containing protein 3.9 3.77 NM_013241 433914 Hs.112160 Homo sapiens DNA helicase homolog (PIF1) mRNA, 3.88 3.75 AF108138 partial cds 420732 Hs.367762 ESTs 3.87 3.74 AA789133 452517 — gb: RC-BT068-130399-068 BT068 Homo sapiens 3.84 3.70 AI904891 cDNA, mRNA sequence 437524 Hs.385719 ESTs, meiosis inhibitor 1, MEI1 3.82 3.68 AI627565 435158 Hs.65588 DAZ associated protein 1 3.8 3.66 AW663317 448780 Hs.267749 Human DNA sequence from clone 366N23 on 3.8 3.65 W92071 chromosome 6q27. Contains two genes similar to consecutive parts of the C. elegans UNC-93 (protein 1, C46F11.1) gene, a KIAA0173 and Tubulin-Tyrosine Ligase LIKE gene, a Mitotic Feedback Control Protein MADP2 H 445084 Hs.250848 hypothetical protein FLJ14761 3.79 3.64 H38914 423138 — gb: EST385571 MAGE resequences, MAGM Homo 3.75 3.60 AW973426 sapiens cDNA, mRNA sequence 419602 Hs.91521 hypothetical protein 3.74 3.59 AW248434 442549 Hs.8375 TNF receptor-associated factor 4 3.74 3.58 AI751601 450893 Hs.25625 hypothetical protein FLJ11323 3.73 3.55 AK002185 414223 Hs.238246 hypothetical protein FLJ22479 3.73 3.55 AA954566 444312 Hs.351142 ESTs 3.72 3.53 R44007 425205 Hs.155106 receptor (calcitonin) activity modifying protein 2 3.71 3.51 NM_005854 432327 Hs.274363 neuroglobin 3.71 3.49 R36571 451970 Hs.211046 ESTs, WD repeat domain 88, WDR88 3.67 3.48 AI825732 408049 Hs.345588 desmoplakin (DPI, DPII) 3.67 3.45 AW076098 440100 Hs.158549 ESTs, Weakly similar to T2D3_HUMAN 3.66 3.45 BE382685 TRANSCRIPTION INITIATION FACTOR TFIID 135 KDA SUBUNIT [H. sapiens] 426468 Hs.117558 ESTs, transcribed locus from chromosome 17 3.65 3.43 AA379306 402384 — NM_007181*: Homo sapiens mitogen-activated 3.64 3.43 — protein kinase kinase kinase kinase 1 (MAP4K1), mRNA. 458132 Hs.103267 hypothetical protein FLJ22548 similar to gene trap 3.64 3.42 AW247012 PAT 12 447400 Hs.18457 hypothetical protein FLJ20315 3.64 3.42 AK000322 443893 Hs.115472 ESTs, Weakly similar to 2004399A chromosomal 3.63 3.41 BE079602 protein [H. sapiens] 424959 Hs.153937 activated p21cdc42Hs kinase 3.62 3.40 NM_005781 409586 Hs.55044 DKFZP586H2123 protein 3.6 3.39 AL050214 445692 Hs.182099 ESTs, Transcription factor B1, mitochondrial 3.6 3.37 AI248322 (TFB1M) 433052 Hs.293003 ESTs, Weakly similar to PC4259 ferritin associated 3.6 3.36 AW971983 protein [H. sapiens] 421782 Hs.108258 actin binding protein; macrophin (microfilament and 3.59 3.35 AB029290 actin filament cross-linker protein) 414907 Hs.77597 polo (Drosophia)-like kinase 3.58 3.34 X90725 454639 — gb: RC2-ST0158-091099-011-d05 ST0158 Homo 3.57 3.33 AW811633 sapiens cDNA, mRNA sequence 434547 Hs.106124 ESTs 3.56 3.32 R26240 439130 Hs.375195 ESTs, family with sequence similarity 101, member 3.55 3.32 AA306090 B, FAM101B 413564 — gb: 601146990F1 NIH_MGC_19 Homo sapiens cDNA 3.54 3.31 BE260120 clone 5′, mRNA sequence 443471 Hs.398102 Homo sapiens clone FLB3442 PRO0872 mRNA, 3.53 3.31 AW236939 complete cds 424415 Hs.146580 enolase 2, (gamma, neuronal) 3.52 3.30 NM_001975 405036 — NM_021628*: Homo sapiens arachidonate 3.52 3.29 — lipoxygenase 3 (ALOXE3), mRNA. VERSION NM_020229.1 GI 422068 Hs.104520 Homo sapiens cDNA FLJ13694 fis, clone 3.52 3.29 AI807519 PLACE2000115 424244 Hs.143601 hypothetical protein hCLA-iso 3.52 3.28 AV647184 451867 Hs.27192 hypothetical protein dJ1057B20.2 3.51 3.26 W74157 429187 Hs.163872 ESTs, Weakly similar to S65657 alpha-1C-adrenergic 3.49 3.26 AA447648 receptor splice form 2 [H. sapiens] 415200 Hs.78202 SWI/SNF related, matrix associated, actin dependent 3.48 3.25 AL040328 regulator of chromatin, subfamily a, member 4 405667 — Target Exon 3.48 3.25 — 421075 Hs.101474 KIAA0807 protein 3.47 3.23 AB018350 424909 Hs.153752 cell division cycle 25B 3.46 3.22 S78187 451164 Hs.60659 ESTs, Weakly similar to T46471 hypothetical protein 3.46 3.21 AA015912 DKFZp434L0130.1 [H. sapiens] 438644 Hs.129037 ESTs 3.46 3.20 AI126162 432258 Hs.293039 ESTs, transcribed locus from chromosome 7 3.45 3.19 AW973078 411817 Hs.72241 mitogen-activated protein kinase kinase 2 3.45 3.19 BE302900 414918 Hs.72222 hypothetical protein FLJ13459 3.45 3.18 AI219207 437256 Hs.97871 Homo sapiens, clone IMAGE: 3845253, mRNA, partial 3.43 3.17 AL137404 cds 404208 — C6001282: gi|4504223|ref|NP_000172.1| 3.42 3.16 — glucuronidase, beta [Homo sapiens] gi|114963|sp|P082 421989 Hs.110457 Wolf-Hirschhorn syndrome candidate 1 3.4 3.15 AJ007042 438942 Hs.6451 PRO0659 protein 3.39 3.14 AW875398 412649 Hs.74369 integrin, alpha 7 3.38 3.14 NM_002206 414840 Hs.23823 hairy/enhancer-of-split related with YRPW motif-like 3.37 3.13 R27319 434831 Hs.273397 KIAA0710 gene product 3.35 3.12 AA248060 431842 Hs.271473 epithelial protein up-regulated in carcinoma, 3.34 3.11 NM_005764 membrane associated protein 17 402328 — Target Exon 3.34 3.10 — 405371 — NM_005569*: Homo sapiens LIM domain kinase 2 3.33 3.10 — (LIMK2), transcript variant 2a, mRNA. 441650 Hs.132545 ESTs, transcribed locus from chromosome 17 3.32 3.09 AI261960 418629 Hs.86859 growth factor receptor-bound protein 7 3.3 3.09 BE247550 406002 — Target Exon 3.3 3.08 — 420307 Hs.66219 ESTs, chromosome 17 open reading frame 56 3.29 3.08 AW502869 (C17orf56) 425093 Hs.154525 KIAA1076 protein 3.28 3.07 AB028999 427351 Hs.123253 hypothetical protein FLJ22009 3.28 3.07 AW402593 417900 Hs.82906 CDC20 (cell division cycle 20, S. cerevisiae, homolog) 3.28 3.06 BE250127 457228 Hs.195471 Human cosmid CRI-JC2015 at D10S289 in 10sp13 3.27 3.05 U15177 421026 Hs.101067 GCN5 (general control of amino-acid synthesis, yeast, 3.27 3.04 AL047332 homolog)-like 2 430746 Hs.406256 ESTs, transcribed locus from chromosome 21 3.27 3.03 AW977370 409556 Hs.54941 phosphorylase kinase, alpha 2 (liver) 3.27 3.03 D38616 451225 Hs.57655 ESTs 3.26 3.03 AI433694 404913 — NM_024408*: Homo sapiens Notch (Drosophila) 3.25 3.02 — homolog 2 (NOTCH2), mRNA. VERSION NM_024410.1 GI 404875 — NM_022819*: Homo sapiens phospholipase A2, group 3.23 3.02 — IIF (PLA2G2F), mRNA. VERSION NM_020245.2 GI 404606 — Target Exon 3.23 3.01 — 414732 Hs.77152 minichromosome maintenance deficient (S. cerevisiae) 7 3.22 3.01 AW410976 425380 Hs.32148 AD-015 protein 3.22 3.00 AA356389 421186 Hs.270563 ESTs, Moderately similar to T12512 hypothetical 3.21 2.98 AI798039 protein DKFZp434G232.1 [H. sapiens] 445462 Hs.288649 hypothetical protein MGC3077 3.2 2.97 AA378776

Permutation Analysis of 100 Most Significantly Up-Regulated Genes in Each Group

By permuting the sample labels 500 times, the significance of the differentially expressed genes was estimated. The permutation analysis revealed that it was highly unlikely to find markers that were as good by chance, as similarly good markers were only found in 5% of the permutated data sets, see Table 2.

Molecular Predictor of Progression

A molecular predictor of progression using a combination of genes may have higher prediction accuracy than when using single marker genes. Therefore, to identify the gene-set that gives the best prediction results using the lowest number of genes, a predictor using the “leave one out” cross-validation approach was built, as previously described (Golub et al. 1999).

Selecting the 100 best genes in each cross-validation loop gave the lowest number of prediction errors (5 errors, 83% correct classification) in the training set consisting of the 29 tumors (see FIG. 2). As in a previous study, a maximum likelihood classification approach was used. A gene-expression signature consisting of those 45 genes that were present in 75% of the cross-validation loops was selected, and these represent the optimal gene-set for progression prediction (Table 3).

Many of these 45 genes were also found among the 200 best markers progression, however, the cross-validation approach also identified other interesting markers of progression like BIRC5 (Survivin), an apoptosis inhibitor that is up regulated in the tumors that show later progression. BIRC5 has been reported to be expressed in most common cancers (Ambrosini et al. 1997). To validate the significance of the 45-gene expression signature, a test set consisting of 19 early stage bladder tumors (9 tumors with no progression and 10 tumors with later progression) was used. Total RNA from these samples were amplified, labeled and hybridized to customized 60-meroligonucleotide microarray glass slides and the relative expressions of the 45 classifier genes were measured following appropriate normalization and background adjustments of the microarray data. The independent tumor samples were classified as non-progressing or progressing according to the degree of correlation to the average no progression profile from the training samples. When applying no cutoff limits to the predictions, the predictor identified 74% of the samples correctly. However, as done recently in a breast cancer study (van't Veer et al. 2002), correlation cutoff limits of 0.1 and −0.1 were applied in order to disregard samples with really low correlation values, and in this way 92% correct prediction of samples with correlation values above 0.1 or below −0.1 were obtained. Although the test-set is limited in size, the performance is notable and could be of clinical use.

TABLE 3 The 45 optimal genes for disease progression prediction. Eos Hu03 Unigene Exemplar ID Build 133 Description T-Test 5% perm Gene Name Accession CV 439010 Hs.75216 protein tyrosine phosphatase, receptor 4.57 4.39 PTPRF AW170332 29 type, F 429124 Hs.196914 minor histocompatibility antigen HA-1 4.20 4.09 HA-1 AW505086 29 421649 Hs.106415 peroxisome proliferative activated 5.76 5.64 PPARD AA721217 29 receptor, delta 433914 Hs.112160 DNA helicase homolog (PIF1) 3.88 3.61 PIF1 AF108138 29 429187 Hs.163872 ESTs, Weakly similar to hypothetical 3.49 3.17 — AA447648 28 protein FLJ20489 422765 Hs.1578 baculoviral IAP repeat-containing 5 2.68 2.56 BIRC5 AW409701 28 (survivin) 433844 Hs.179647 ESTs 4.04 3.80 SLC25A29 AA610175 26 450893 Hs.25625 Hypothetical protein FLJ11323 3.73 3.46 FLJ11323 AK002185 25 452866 Hs.268016 ESTs 3.10 3.02 SLC5A3 R26969 24 424909 Hs.153752 cell division cycle 258 3.46 3.16 CDC25B S78187 24 452929 Hs.172816 neuregulin 1 4.37 4.23 NRG1 AW954938 23 420116 Hs.95231 formin homology 2 domain containing 1 3.90 3.63 FHOD1 NM_013241 22 453963 Hs.28959 cDNA FLJ36513 fis, clone TRACH2001523 3.44 2.88 BMPR2 AA040311 29 429561 Hs.250646 baculoviral IAP repeat-containing 6 3.83 3.03 BIRC6 AF265555 29 (apollon) 418127 Hs.83532 membrane cofactor protein (CD46, 4.26 3.37 MCP BE243982 29 trophoblast-lymphocyte cross-reactive antigen) 422119 Hs.111862 KIAA0590 gene product 2.33 1.95 KIAA0590 AI277829 29 435521 Hs.6361 mitogen-activated protein kinase kinase 1 5.24 4.53 MAP2K1IP1 W23814 29 interacting protein 1 409632 Hs.55279 serine (or cysteine) proteinase inhibitor, 4.89 4.11 SERPINB5 W74001 29 clade B (ovalbumin), member 5 452829 Hs.63368 ESTs 4.95 4.31 MAN2A1 AI955579 29 416640 Hs.79404 DNA segment on chromosome 4 (unique) 6.03 5.51 D4S234E BE262478 29 234 expressed sequence 425097 Hs.154545 PDZ domain containing guanine 3.77 3.18 PDZ-GEF1 NM_014247 28 nucleotide exchange factor(GEF)1 445926 Hs.334826 splicing factor 3b, subunit 1, 155 kDa 2.40 2.03 SF3B1 AF054284 28 437325 Hs.5548 F-box and leucine-rich repeat protein 5 2.48 2.09 FBXL5 AF142481 28 448813 Hs.22142 cytochrome b5 reductase b5R.2 4.28 3.41 LOC51700 AF169802 28 426799 Hs.303154 ESTs 4.86 4.04 IDS H14843 28 446847 Hs.82845 ESTs 4.65 3.79 SOLR1 T51454 28 428016 Hs.181461 ariadne homolog, ubiquitin-conjugating 3.77 3.15 ARIH1 AJ243190 27 enzyme E2 binding protein, 1 (Drosophila) 418321 Hs.84087 KIAA0143 protein 4.62 3.76 KIAA0143 D63477 27 422984 Hs.351597 ESTs 3.50 2.93 PLEKHB2 W28614 26 408688 Hs.152925 KIAA1268 protein 3.52 2.95 KIAA1268 AI634522 26 440357 Hs.20950 phospholysine phosphohistidine inorganic 3.89 3.07 LHPP AA379353 26 pyrophosphate phosphatase 420269 Hs.96264 alpha thalassemia/mental retardation 3.39 2.85 ATRX U72937 26 syndrome X-linked (RAD54 (S. cerevisiae) homolog) 423185 Hs.38006 ornithine decarboxylase antizyme 1 4.61 3.71 OAZ1 BE299590 26 443407 Hs.348514 clone IMAGE: 4052238, mRNA, partial cds 4.21 3.32 TMEM33 AA037683 25 457329 Hs.359682 calpastatin 3.59 2.99 CAST AI634860 25 452714 Hs.30340 KIAA1165: likely ortholog of mouse Nedd4 3.62 3.01 KIAA1165 AW770994 25 WW domain-binding protein 5A 444773 Hs.11923 hypothetical protein DJ167A19.1 3.71 3.11 DJ167A19.1 BE156256 24 418504 Hs.85335 ESTs 4.59 3.67 TMEM30B BE159718 24 444604 Hs.11441 Chromosome 1 open reading frame 8 4.89 4.17 C1orf8 AW327695 23 410691 Hs.65450 reticulon 4 RTN4 AW239226 23 430604 Hs.247309 succinate-CoA ligase, GDP-forming, beta 4.61 3.72 SUCLG2 AV650537 23 subunit 421311 Hs.283609 muscleblind-like protein MBLL39 4.65 3.82 MBLL39 N71848 23 439632 Hs.334437 hypothetical protein MGC4248 4.29 3.42 MGC4248 AW410714 22 417924 Hs.82932 cyclin D1 (PRAD1: parathyroid 4.35 3.49 CCND1 AU077231 22 adenomatosis 1) 453395 Hs.377915 mannosidase, alpha, class 2A, 4.71 3.84 MAN2A1 D63998 22 member 1

Permutation Analysis of 45 Genes

Again permutation analysis revealed that for all of the 45 genes similarly good markers were only found in 5% of the 500 permuted datasets (see Table 3).

Expression Profiling of Metachrone Higher Stage Tumors

Expression profiling of the metachrone higher stage tumors could provide important information on the degree of expression similarities between the primary and the secondary tumors. Tissues from secondary tumors were available from 14 of the patients with disease progression and these were also hybridized to the customized Affymetrix GeneChips.

Hierarchical cluster analysis of all tumor samples based on the 3,213 most varying probe sets showed that tumors originating from the same patient in 9 of the cases clustered tightly together, indicating a high degree of intra individual similarity in expression profiles (FIG. 3). Notably, one tightly clustering pair of tumors was a Ta and a T2+ tumor (patient 941). It was remarkable that Ta and T1 tumors and T1 or T2+ tumors from a single individual were more similar than e.g. Ta tumors from two individuals. There was no correlation between presence and absence of the tight clustering of samples from the same patient and time interval to tumor progression. The tight clustering of the 9 tumor pairs probably reflects the monoclonal nature of many bladder tumors (Sidransky et al. 1997). A set of genomic abnormalities like chromosomal gains and losses characterize bladder tumors of different stages from single individuals (Primdahl et al. 2002), and such physical abnormalities could be one of the causes of the strong similarity of metachronous tumors. The fact that 5 of the tumor pairs clustered apart may be explained by an oligoclonal origin of these tumors.

Customized GeneChip Design, Normalization and Expression Measures

We used a customized Affymetrix GeneChip (Eos Hu03) designed by Eos Biotech Inc., as described (Eaves et al. 2002). Approximately 45,000 mRNA/EST clusters and 6,200 predicted exons are represented by the 59,000 probe sets on Eos Hu03 array. Data were normalized using protocols and software developed at Eos Biotechnology, Inc. (W00079465). An “average intensity” (AI) for each probe set was calculated by taking the trimean of probe intensities following background subtraction and normalization to a gamma distribution (Turkey 1977).

cRNA Preparation, Array Hybridization and Scanning

Preparation of cRNA from Total RNA and Subsequent Hybridization and Scanning of the customized GeneChip microarrays (Eos Hu03) were performed as described previously (Dyrskjot et al. 2003).

Custom Oligonucleotide Microarray Procedures

Three 60-mer oligonucleotides were designed for each of the 45 genes using Array Designer 2.0. All steps in the customized oligonucleotide microarray analysis were performed essentially as described (Kruhoffer et al.) Each of the probes was spotted in duplicates and all hybridizations were carried out twice. The samples were labeled with Cy3 and a common reference pool was labelled with Cy5. The reference pool was made by pooling of cRNA generated from investigated samples and from universal human RNA. Following scanning of the glass slides the fluorescent intensities were quantified and background adjusted using SPOT 2.0 (Jain et al. 2002). Data were subsequently normalized using a LOWESS normalization procedure implemented in the SMA package to R. To select the best oligonucleotide probe for each of the 45 genes, 13 of the samples from the training set were re-analyzed on the custom oligonucleotide microarray platform and the obtained expression ratios were compared to the expression levels from the Affymetrix GeneChips. The oligonucleotide probes with the highest correlation to the Affymetrix GeneChip probes were selected.

Expression Data Analysis

Before analysing the expression data from the Eos Hu03 GeneChips control probes were removed and only probes with AI levels above 100 in at least 8 experiments and with max/min equal to or above 1.6 were selected. This filtering generated a gene-set consisting of 6,647 probes for further analysis. Average linkage hierarchical cluster analysis of the tumour samples was carried out using a modified Pearson correlation as a similarity metric (Eisen et al. 1998). Genes and arrays were median centered and normalized to the magnitude of 1 before clustering. We used the GeneCluster 2.0 software for the supervised selection of markers and for performing permutation tests. The 45 genes for predicting progression were selected by t-test statistics and cross-validation performance as previously described (Dyrskjot et al. 2003) and independent samples were classified according to the correlation to the average no progression signature profile of the 45 genes.

Example 2 Identifying Distinct Classes of Bladder Carcinoma Using Microarrays Patient Disease Course Information—Class Discovery

We selected tumors from the entire spectrum of bladder carcinoma for expression profiling in order to discover the molecular classes of the disease. The tumors analyzed are listed in Table 4 below together with the available patient disease course information.

TABLE 4 Disease course information of all patients involved-class discovery. Tumor examined Reviewed Carcinoma in Group Patient Previous tumors on array Pattern histology Subsequent tumors situ* A 709-1 Ta gr 2 (200297) Papillary Ta gr3 no 968-1 Ta gr 2 (011098) Papillary + Ta gr 2 (150101) no 934-1 Ta gr 2 (220798) Papillary + no 928-1 Ta gr 2 (240698) Papillary + no 930-1 Ta gr 2 (300698) Papillary + no B 989-1 Ta gr 3 (281098) Papillary + no 1264-1 Ta gr 3 (130600) Papillary + Ta gr 2 (231000) no Ta gr 2 (220101) Ta gr 2 (300401) 876-5 Ta gr 2 (230398) Ta gr 3 (170400) Papillary + no Ta gr 2 (271098) Ta gr 2 (090699) Ta gr 2 (011199) 669-7 Ta gr 2 (101296) Ta gr 3 (230899) Papillary Ta gr2 Ta gr 2 (120100) no Ta gr 2 (150897) Ta gr 2 (250500) Ta gr 1 (161297) Ta gr 2 (250900) Ta gr 3 (270498) Ta gr 2 (050201) Ta gr 2 (220299) 716-2 Ta gr 2 (070397) Ta gr 3 (230497) Papillary + Ta gr 2 (040697) no Ta gr 1 (170698) C 1070-1 Ta gr 3 (150399) Papillary + Ta gr 3 (291099) Subsequent visit 956-2 Ta gr 3 (061299) Papillary + Ta gr 3 (061200) Sampling visit 1062-2 Ta gr 3 (120799) Papillary + T1 gr 3 (161199) Sampling visit 1166-1 Ta gr 3 (271099) Papillary + Sampling visit 1330-1 Ta gr 3 (311000) Papillary + Sampling visit D 112-10 Ta gr 2 (070794) Ta gr 3 (060198) Papillary + Ta gr 3 (110698) Previous visit Ta gr 3 (011294) T1 gr 3 (191098) T1 gr 3(150695) Ta gr 3 (240299) Ta gr 3 (121095) T1 gr 3 (050799) T1 gr 3(040396) T1 gr 3 (081199) Ta gr 2 (200896) T1 gr 3 (180400) Ta gr 2 (111296) Ta gr 2 (230497) Ta gr 2 (030997) 320-7 T1 gr 3 (011194) Ta gr 3 (290997) Papillary + Ta gr 3 (290198) Sampling visit T1 gr 3 (150896) Ta gr 3 (290698) Ta gr 3 (100897) 747-7 Ta gr 2 (010597) Ta gr 3 (161298) Papillary + Ta gr 2 (050599) Sampling visit Ta gr 2 (220597) Ta gr 2 (280999) Ta gr 2 (230997) Ta gr 2 (141299) Ta gr 2 (260198) T1 gr 3 (270498) Ta gr 2 (170898) 967-3 T1 gr 3 (280998) Ta gr 3 (140699) Papillary + T1 gr 3 (080999) Sampling visit T1 gr 3 (250199) E 625-1 T1 gr 3 (200996) Papillary + No 847-1 T1 gr 3 (210198) Papillary + No 1257-1 T1 gr 3 (240500) Solid + Sampling visit 919-1 T1 gr 3 (220698) Papillary + No 880-1 T1 gr 3 (300398) Papillary + Ta gr 2 (091198) No Ta gr 1 (090399) Ta gr 2 (050900) Ta gr 2 (190301) 812-1 T1 gr 3 (061098) Papillary + No 1269-1 T1 gr 3 (230600) Papillary − No 1083-2 Ta gr 2 (280499) T1 gr 3 (120599) Papillary − No 1238-1 T1 gr 3 (020500) Papillary + T2 gr 3 (211100) No Ta gr 2 (211100) 1065-1 T1 gr 3 (160399) Papillary − Subsequent visit 1134-1 T1 gr 3 (181099) Papillary T2 gr3 T1 gr 3 (280200) Sampling visit T1 gr 3 (020500) T1 gr 3 (131100) F 1164-1 T2+ gr 4 (101299) Solid gr 3 No 1032-1 T2+ gr ? (050199) Mixed − Not measured 1117-1 T2+ gr 3 (010999) Solid + Sampling visit 1178-1 T2+ gr 3 (200100) Solid + Not measured 1078-1 T2+ gr 3 (120499) Solid + Not measured 875-1 T2+ gr 3 (180398) Solid + No 1044-1 T2+ gr 3 (010299) Solid + T2+ gr 3 (060999) Not measured 1133-1 T2+ gr 3 (081099) Solid + Not measured 1068-1 T2+ gr 3 (220399) Solid + No 937-1 T2+ gr 3 (280798) Solid − Not measured Group A: Ta gr2 tumours—no recurrence within 2 years. Group B: Ta gr3 tumours—no prior T1 tumour and no carcinoma in situ in random biopsies. Group C: Ta gr3 tumours—no prior T1 tumour but carcinoma in situ in random biopsies. Group D: Ta gr3 tumours—a prior T1 tumour and carcinoma in situ in random biopsies. Group E: T1 gr3 tumours—no prior T2+ tumour. Group F: T2+ tumours gr3/4—only primary tumours. *Carcinoma in situ detected in selected site biopsies at previous, sampling or subsequent visits.

Two-Way Hierarchical Cluster Analysis of Tumor Samples

A two-way hierarchical cluster analysis of the tumor samples based on the 1767 gene-set (see class discovery using hierarchical clustering) remarkably separated all 40 tumors according to conventional pathological stages and grades with only few exceptions (FIG. 4A). Two main branches were identified containing the superficial Ta tumors, and the invasive T1 and T2+ tumors. In the superficial branch, two sub-clusters of tumors could be identified, one holding 8 tumors that had frequent recurrences and one holding 3 out of the five Ta grade 2 tumors with no recurrences. In the invasive branch, it was notable that four Ta grade 3 tumors clustered tightly with the muscle invasive T2+ tumors. These four Ta tumors, from patients with no previous tumor history, showed concomitant CIS in the surrounding mucosa, indicating that this sub-fraction of Ta tumors has some of the more aggressive features found in muscle invasive tumors. The stage T1 cluster could be separated into three sub-clusters with no clear clinical difference. The one stage T1 grade 3 tumor that clustered with the stage T2+ muscle invasive tumors was the only T1 tumor that showed a solid growth pattern, all others showing papillary growth. Nine out of ten T2+ tumors were found in one single cluster. The remarkable distinct separation of the tumor groups according to stage, with practically no overlap between groups, was also demonstrated by multidimensional scaling analysis (FIG. 4C).

In an attempt to reduce the number of genes needed for class prediction, those genes were identified that were scored by the Cancer Genome Anatomy Project (at NCI) as belonging to cancer-related groups such as tumor suppressors, oncogenes, cell cycle, etc. These genes were then selected from the initial 1767 gene-set, and those 88 which showed largest variation (SD of the gene vector ≧4), were used for hierarchical clustering of the tumor samples. The obtained cluster was almost identical to the 1767 gene-set cluster dendrogram (FIG. 4B), indicating that the tumor clustering does not simply reflect larger amounts of stromal components in the invasive tumour biopsies.

The clustering of the 1767 genes revealed several characteristic profiles in which there was a distinct difference between the tumor groups.

Cluster a of the 1767 genes, showed a high expression level in all the Ta grade 3 tumors (FIG. 7a in application Ser. No. 12/180,321) and, as a novel finding, contains genes encoding 8 transcription factors as well as other nuclear genes related to transcriptional activity. Cluster c (FIG. 7c in application Ser. No. 12/180,321) contains genes that are up-regulated in Ta grade 3 with a high recurrence rate and CIS, in T2+ and some T1 tumors. This cluster c shows a remarkably tight co-regulation of genes related to cell cycle control and mitosis. Genes encoding cyclins, PCNA as well as a number of centromere related proteins are present in this cluster. They indicate increased cellular proliferation and may form new targets for small molecule therapy (Seymour 1999). Cluster f shows a tight cluster of genes related to keratinization (FIG. 7f in application Ser. No. 12/180,321). Two tumors (875-1 and 1178-1) had a very high expression of these genes and a re-evaluation of the pathology slides revealed that these were the only two samples to show squamous metaplasia. Thus, activation of this cluster of genes promotes the squamous metaplasia not infrequently seen by light microscopy in invasive bladder tumors. The genes in this cluster are listed in Table 5.

TABLE 5 Genes for classifying samples with squamous metaplasia UniGene Chip acc. # Build 162 description D83657_at Hs.19413 NM_005621; S100 calcium-binding protein A12 HG3945-HT4215_at J00124_at Keratin 14; KRT14 L05187_at Small proline-rich protein 1A SPRK; SPRR1A L05188_f_at Hs.505327 Small proline-rich protein 2B; SPRR2B L10343_at Hs.112341 NM_002638; skin-derived protease inhibitor 3 preproprotein L42583_f_at Hs.367762 NM_005554; keratin 6A L42601_f_at Hs.367762 NM_005554; keratin 6A L42611_f_at Hs.446417 NM_173086; keratin 6 isoform K6e M19888_at Hs.1076 NM_003125; small proline-rich protein 1B (cornifin) M20030_f_at Hs.505352 Small proline-rich protein 2E; SPRR2E M21005_at S100 calcium binding protein A8; S100A8 M21302_at Hs.505327 Small proline-rich protein 2D; SPRR2D M21539_at Hs.2421 NM_006518; small proline-rich protein 2C M86757_s_at Hs.112408 NM_002963; S100 calcium- binding protein A7 S72493_s_at Hs.432448 NM_005557; keratin 16 U70981_at Hs.336046 NM_000640; interleukin 13 receptor, alpha 2 precursor V01516_f_at Hs.367762 NM_005554; keratin 6A X53065_f_at Small proline-rich protein 2A; SPRR2A X57766_at Hs.143751 NM_005940; matrix metalloproteinase 11 preproprotein Z19574_rna1_at Keratin 17; KRT17

Cluster g contains genes that are up-regulated in T2+ tumors and in the Ta grade 3 tumors with CIS that cluster in the invasive branch (FIG. 7g in application Ser. No. 12/180,321). This cluster contains genes related to angiogenesis and connective tissue such as laminin, myosin, caldesmon, collagen, dystrophin, fibronectin, and endoglin. The increased transcription of these genes may indicate a profound remodeling of the stroma that could reflect signaling from the tumor cells, from infiltrating lymphocytes, or both. Some of these may also form new drug targets (Fox et al. 2001). It is remarkable that these genes are those that most clearly separate the Ta grade 3 tumors surrounded by CIS from all other Ta grade 3 tumors. The presence of adjacent CIS is usually diagnosed by taking a set of eight biopsies from different places in the bladder mucosa. However, the present data clearly indicate that analysis of stroma remodeling genes in the Ta tumors could eliminate this invasive procedure.

The clusters b, d, e, h, i, and j contain genes related to nuclear proteins, cell adhesion, growth factors, stromal proteins, immune system, and proteases, respectively (see FIG. 8 in application Ser. No. 12/180,321). A summary of the stage related gene expression is shown in Table 6.

TABLE 6 Table 6 Summary of stage related gene expression Functional gene clusters^(a) Nuclear Matrix Extracellular Immune Tumor stage Transcription processes Proliferation remodelling matrix system Ta gr2 ↑ — — — ↓↓ ↓ Ta gr3 ↑↑↑ ↑↑ ↑↑ — ↓↓ ↓ T1 gr3 ↑^(b) — ↑↑^(b) — ↓ ↑^(b) T2 gr3 ↑ — ↑↑↑ ↑↑↑ ↑ ↑ Ta gr3 + CIS ↑↑↑ ↑↑ ↑↑↑ ↑↑↑ ↑ ↑ ^(a)For a detailed description of gene clusters see FIG. 8. ^(b)An increase in gene expression was only found in about half of the samples analysed.

Class Prediction of Bladder Tumors

An objective class prediction of bladder tumors based on a limited gene-set is clinically useful. A classifier was built using tumors correctly separated in the three main groups as identified in the cluster dendrogram (FIG. 4A). A maximum likelihood classification method was used with a “leave one out” cross-validation scheme (Shipp et al. 2002; van't Veer et al. 2002) in which one test tumor was removed from the set, and a set of predictive genes was selected from the remaining tumor samples for classifying the test tumor. This process was repeated for all tumors. Predictive genes that showed the largest possible separation of the three groups were selected for classification, and each tumor was classified according to how close it was to the mean of the three groups (FIG. 8a in application Ser. No. 12/180,321).

Classification of Samples

From the hierarchical cluster analysis of the samples (class discovery) three major “molecular classes” of bladder carcinoma highly associated with the pathologic staging of the samples were identified. Based on this finding it was decided to build a molecular classifier that assigns tumors to these three “molecular classes.” To build the classifier, only the tumours in which there was a correlation between the “molecular class” and the associated pathologic stage were used. Consequently, a T1 tumour clustering in the “molecular class” of T2 tumours was not used to build the classifier.

The genes used in the classifier were those genes with the highest values of the ratio (B/W) of the variation between the groups (B) to the variation within the groups (W). High values of the ratio (B/W) signify genes with good group separation performance. The sum over the genes of the squared distance from the sample value to the group mean was calculated, and the sample classified as belonging to the group where the distance to the group mean was smallest. If the relative difference between the distance to the closest and the second closest group compared to the distance to the closest group was below 5%, the classification failed and the sample was classified as belonging to both groups. The relative difference is referred to as the classifier strength.

Classifier Performance

The classifier performance was tested using from 1-160 genes in cross-validation loops. FIG. 6 shows that the closest correlation to histopathology is obtained in the cross-validation model using from 69-97 genes. Based on this the model, using 80 genes for cross-validation was chosen as the final classifier model.

Classifier Model Using 71 Genes

The genes selected for the final classifier model were those that were used in at least 75% (25 times) of the cross-validation loops. These 71 genes are listed in table 7.

TABLE 7 Feature: Accession number on HuGene fl array. Number: Number of times used in the 80 genes cross validation loops. Test (B/W): see below. Unigene Feature Build 162 Description Number Test (B/W) AF000231_at Hs.75618 NM_004663; Ras-related protein Rab-11A 33 26.77 D13666_s_at Hs.136348 NM_006475; osteoblast specific factor 2 (fasciclin I-like) 33 27.71 D49372_s_at Hs.54460 NM_002986; small inducible cytokine A11 precursor 31 25.78 D83920_at Hs.440898 NM_002003; ficolin 1 precursor 33 31.18 D86479_at Hs.439463 NM_001129; adipocyte enhancer binding protein 1 precursor 33 28.29 D89077_at Hs.75367 NM_006748; Src-like-adaptor 33 30.03 D89377_at Hs.89404 NM_002449; msh homeo box homolog 2 33 51.50 HG4069-HT4339_s_at 27 25.06 HG67-HT67_f_at 33 27.81 HG907-HT907_at 33 25.76 J02871_s_at Hs.436317 NM_000779; cytochrome P450, family 4, subfamily B, 33 32.61 polypeptide 1 J03278_at Hs.307783 NM_002609; platelet-derived growth factor receptor beta 33 28.02 precursor J04058_at Hs.169919 NM_000126; electron transfer flavoprotein, alpha polypeptide 33 29.46 J05032_at Hs.32393 NM_001349; aspartyl-tRNA synthetase 33 38.21 J05070_at Hs.151738 NM_004994; matrix metalloproteinase 9 preproprotein 33 35.34 J05448_at Hs.79402 NM_002694; DNA directed RNA polymerase II polypeptide C 32 26.51 NM_032940; DNA directed RNA polymerase II polypeptide C K01396_at Hs.297681 NM_000295; serine (or cysteine) proteinase inhibitor, clade A 33 28.66 (alpha-1 antiproteinase, antitrypsin), member 1 L13720_at Hs.437710 NM_000820; growth arrest-specific 6 33 29.69 M12125_at Hs.300772 NM_003289; tropomyosin 2 (beta) 28 24.89 M15395_at Hs.375957 NM_000211; integrin beta chain, beta 2 precursor 33 29.40 M16591_s_at Hs.89555 NM_002110; hemopoietic cell kinase isoform p61HCK 33 32.34 M20530_at Serine peptidase inhibitor; SPINK1 33 30.28 M23178_s_at Hs.73817 NM_002983; chemokine (C-C motif) ligand 3 33 35.36 M32011_at Hs.949 NM_000433; neutrophil cytosolic factor 2 33 41.88 M33195_at Hs.433300 NM_004106; Fc fragment of IgE, high affinity I, receptor for, 33 30.40 gamma polypeptide precursor M55998_s_at Hs.172928 NM_000088; alpha 1 type I collagen preproprotein 33 26.83 M57731_s_at Hs.75765 NM_002089; chemokine (C—X—C motif) ligand 2 33 31.84 M68840_at Hs.183109 NM_000240; monoamine oxidase A 33 32.39 M69203_s_at Hs.75703 NM_002984; chemokine (C-C motif) ligand 4 precursor 33 36.21 M72885_rna1_s_at G0/G1 switch 2 RP1-28O10.2; G0S2 33 27.94 M83822_at Hs.209846 NM_006726; LPS-responsive vesicle trafficking, beach and 33 26.44 anchor containing S77393_at Hs.145754 NM_016531; Kruppel-like factor 3 (basic) 33 49.85 U01833_at Hs.81469 NM_002484; nucleotide binding protein 1 (MinD homolog, E. coli) 33 30.62 U07231_at Hs.309763 NM_002092; G-rich RNA sequence binding factor 1 33 39.10 U09937_rna1_s_at Plasminogen activator, urokinase receptor CD87; PLAUR 33 30.88 U10550_at Hs.79022 NM_005261; GTP-binding mitogen-induced T-cell protein 28 25.26 NM_181702; GTP-binding mitogen-induced T-cell protein U20158_at Hs.2488 NM_005565; lymphocyte cytosolic protein 2 33 32.41 U41315_rna1_s_at Makorin ring finger protein 1; MKRN1 33 43.56 U47414_at Hs.13291 NM_004354; cyclin G2 33 44.42 U49352_at Hs.414754 NM_001359; 2,4-dienoyl CoA reductase 1 precursor 33 37.04 U50708_at Hs.1265 NM_000056; branched chain keto acid dehydrogenase E1, 33 42.89 beta polypeptide precursor NM_183050; branched chain keto acid dehydrogenase E1, beta polypeptide precursor U52101_at Hs.9999 NM_001425; epithelial membrane protein 3 33 29.86 U64520_at Hs.66708 NM_004781; vesicle-associated membrane protein 3 33 30.17 (cellubrevin) U65093_at Hs.82071 NM_006079; Cbp/p300-interacting transactivator, with 33 32.07 Glu/Asp-rich carboxy-terminal domain, 2 U68019_at Hs.288261 NM_005902; MAD, mothers against decapentaplegic homolog 3 31 26.70 U68385_at Hs.380923 Meis homeobox 3 pseudogene 1; MEIS3P1 33 31.56 U74324_at Hs.90875 NM_002871; RAB-interacting factor 33 30.26 U77970_at Hs.321164 NM_002518; neuronal PAS domain protein 2 NM_032235; 33 50.37 U90549_at Hs.236774 NM_006353; high mobility group nucleosomal binding domain 4 33 32.16 X04085_rna1_at Catalase; CAT 28 25.13 X07743_at Hs.77436 NM_002664; pleckstrin 33 28.13 X13334_at Hs.75627 NM_000591; CD14 antigen precursor 33 35.79 X14046_at Hs.153053 NM_001774; CD37 antigen 30 24.70 X15880_at Hs.415997 NM_001848; collagen, type VI, alpha 1 precursor 33 31.51 X15882_at Hs.420269 NM_001849; alpha 2 type VI collagen isoform 2C2 precursor 33 32.32 NM_058174; alpha 2 type VI collagen isoform 2C2a precursor NM_058175; alpha 2 type VI collagen isoform 2C2a precursor X51408_at Hs.380138 NM_001822; chimerin (chimaerin) 1 33 30.51 X53800_s_at Hs.89690 NM_002090; chemokine (C—X—C motif) ligand 3 33 33.63 X54489_rna1_at Chemokine (C—X—C motif) ligand 1 (melanoma growth 33 33.57 stimulating activity, alpha); CXCL1 X57579_s_at Inhibin, beta A; INHBA 33 41.43 X64072_s_at Hs.375957 NM_000211; integrin beta chain, beta 2 precursor 33 43.21 X67491_f_at Hs.355697 NM_005271; glutamate dehydrogenase 1 33 30.97 X68194_at Hs.80919 NM_006754; synaptophysin-like protein isoform a 33 46.53 NM_182715; synaptophysin-like protein isoform b X73882_at Hs.254605 NM_003980; microtubule-associated protein 7 33 53.16 X78520_at Hs.372528 NM_001829; chloride channel 3 33 47.38 Y00787_s_at Hs.624 NM_000584; interleukin 8 precursor 32 27.54 Z12173_at Hs.334534 NM_002076; glucosamine (N-acetyl)-6-sulfatase precursor 30 25.44 Z19554_s_at Hs.435800 NM_003380; vimentin 27 24.59 Z26491_s_at Hs.240013 NM_000754; catechol-O-methyltransferase isoform MB-COMT 32 26.92 NM_007310; catechol-O-methyltransferase isoform S-COMT Z29331_at Hs.372758 NM_003344; ubiquitin-conjugating enzyme E2H isoform 1 33 33.49 NM_182697; ubiquitin-conjugating enzyme E2H isoform 2 Z48605_at Hs.421825 NM_006903; inorganic pyrophosphatase 2 isoform 2 33 44.45 NM_176865; NM_176866; inorganic pyrophosphatase 2 isoform 3 NM_176867; inorganic pyrophosphatase 2 isoform 4 NM_176869; inorganic pyrophosphatase 2 isoform 1 Z74615_at Hs.172928 NM_000088; alpha 1 type I collagen preproprotein 33 55.18

Test for Significance of Classifier

To test the class separation performance of the 71 selected genes we compared the B/W ratios with the similar ratios of all the genes calculated from permutations of, the arrays. For each permutation we constructed three pseudogroups, pseudo-Ta, pseudo-T1, and pseudo-T2, so that the proportion of samples from the three original groups was approximately the same in the three pseudogroups. We then calculated the ratio of the variation between the pseudogroups to the variation within the pseudogroups for all the genes. In 500 permutations only twice did we see one gene for which the B/W value was higher than the lowest value for the original B/W values of the 71 selected genes (the two values being 25.28 and 25.93).

The classifier performance was tested using from 1-160 genes in cross-validation loops, and a model using an 80 gene cross-validation scheme showed the best correlation to pathologic staging (p<10⁻⁹). The 71 genes that were used in at least 75% of the cross validation loops were selected to constitute our final classifier model. See the expression profiles of the 71 genes in FIG. 10. The genes are clustered to obtain a better overview of similar expression patterns. From this it is obvious that the T1 stage is characterized by having expression patterns in common with either Ta or T2 tumours. There are no single genes that can be used as a T1 marker.

Permutation Analysis

To test the class separation performance of the 71 selected genes we compared their performance to those of a permutated set of pseudo-Ta, T1 and T2 tumours. In 500 permutations we only detected two genes with a performance equal to the poorest performing classifying genes.

Classification Using 80 Predictive Genes and Other Gene-Sets

The classification using 80 predictive genes in cross-validation loops identified the Ta group with no surrounding CIS and no previous tumor or no previous tumor of a higher stage (Table 8). Interestingly, the Ta tumours surrounded by CIS that were classified as T2 or T1 clearly demonstrate the potential of the classification method for identifying surrounding CIS in a non-invasive way, thereby supplementing clinical and pathologic information.

TABLE 8 Clinical data on disease courses and results of molecular classification Carcinoma Molecular Previous Tumor Subsequent in Reviewed classifier^(c) Tumors Patient tumors analysed tumors situ^(a) histology^(b) 320 80 20 Ta grade II tumors - 709-1 Ta gr2 No Ta gr3 Ta Ta Ta no progression 908-1 Ta gr2 1 Ta No Ta/T1 Ta Ta 934-1 Ta gr2 No T1 Ta Ta 928-1 Ta gr2 No Ta Ta T1 930-1 Ta gr2 No Ta Ta Ta Ta grade III tumors - 989-1 Ta gr3 No Ta Ta Ta no prior T1 tumor 1264-1 Ta gr3 3 Ta No Ta Ta Ta or CIS 876-5 4 Ta Ta gr3 No Ta Ta Ta 669-7 5 Ta Ta gr3 4 Ta No Ta gr2 Ta Ta Ta 716-2 1 Ta Ta gr3 2 Ta No Ta Ta Ta Ta grade III tumors - 1070-1 Ta gr3 1 Ta Subsequent Ta Ta Ta no prior T1 tumor but visit CIS in selected site 956-2 Ta gr3 1 Ta Sampling T2 T2 T2/T1 biopsies visit 1062-2 Ta gr3 1 T1 Sampling T2/Ta T1/Ta Ta visit 1166-1 Ta gr3 Sampling Ta/T1 Ta Ta visit 1330-1 Ta gr3 Sampling T2 T2 Ta visit Ta grade III tumors - 747-7 5 Ta, 1 T1 Ta gr3 3 Ta Sampling Ta Ta Ta a prior T1 tumor and visit CIS in selected site 112-10 7 Ta, 2 T1 Ta gr3 2 Ta, 4 T1 Previous Ta Ta Ta biopsies visit 320-7 1 Ta, 2 T1 Ta gr3 2 Ta Sampling T2 T2 Ta visit 967-3 2 T1 Ta gr3 1 T1 Sampling Ta Ta Ta visit T1 grade III tumors - 625-1 T1 gr3 No T1 T1 T1 no prior muscle 847-1 T1 gr3 No T1 T1 T1 invasive tumor 1257-1 T1 gr3 Sampling T1 T1 T1 visit 919-1 T1 gr3 No T1 T1 T1 880-1 T1 gr3 4 Ta No T1 T1 T1 812-1 T1 gr3 No T1 T1 T1 1269-1 T1 gr3 No No review T1 T1 T1 1083-2 1 Ta T1 gr3 No No review T1 T1 T1 1238-1 T1 gr3 1 Ta, 1 T2+ No T1 T1 T1 1065-1 T1 gr3 Subsequent No review T1 T1 T1 visit 1134-1 T1 gr3 3 T1 Sampling T2 gr3 T1 T1 T1 visit T2+ grade III/IV 1164-1 T2+ gr4 No T2+ gr3 T2/T1 T1 T1 tumors - only primary 1032-1 T2+ gr? ND No review T2 T2 T2 tumors 1117-1 T2+ gr3 ND T2 T2 T1 1178-1 T2+ gr3 ND T2 T2 T2 1078-1 T2+ gr3 ND T2 T2 T2 875-1 T2+ gr3 No T2 T2 T2 1044-1 T2+ gr3 1 T2+ ND T2 T2 T2 1133-1 T2+ gr3 ND T2 T2 T2 1068-1 T2+ gr3 No T2 T2 T2 937-1 T2+ gr3 ND No review T1 T1 T1 ^(a)Carcinoma in situ detected in selected site biopsies at the time of sampling tumor tissue for the arrays or at previous or subsequent visits. ^(b)All tumors were reviewed by a single uro-pathologist and any change compared to the routine classification is listed. ^(c)Molecular classification based on 320, 80, and 20 genes cross-validation loops.

Classification Using Other Gene-Sets

Classification was also carried out using other gene-sets (10, 20, 32, 40, 80, 160, and 320 genes). These gene-sets demonstrated the same classification tendency as the 71 genes. See Tables 9-15 for gene-sets.

TABLE 9 320 genes for classifier UniGene Chip acc. # Build 162 description AB000220_at Hs.171921 NM_006379; semaphorin 3C AB000220_at Hs.171921 NM_006379; semaphorin 3C AC002073_cds1_at Phosphoinositide-3-kinase interacting protein 1; PIK3IP1 AF000231_at Hs.75618 NM_004663; Ras-related protein Rab-11A D10922_s_at Hs.99855 NM_001462; formyl peptide receptor-like 1 D10925_at Hs.301921 NM_001295; chemokine (C-C motif) receptor 1 D11086_at Hs.84 NM_000206; interleukin 2 receptor, gamma chain, precursor D11151_at Hs.211202 NM_001957; endothelin receptor type A D13435_at Hs.426142 NM_002643; phosphatidylinositol glycan, class F isoform 1 NM_173074; phosphatidylinositol glycan, class F isoform 2 D13666_s_at Hs.136348 NM_006475; osteoblast specific factor 2 (fasciclin I-like) D14520_at Hs.84728 NM_001730; Kruppel-like factor 5 D21878_at Hs.169998 NM_004334; bone marrow stromal cell antigen 1 precursor D26443_at Hs.371369 NM_004172; solute carrier family 1 (glial high affinity glutamate transporter), member 3 D28589_at Hs.17719 KIAA0114 D42046_at Hs.194665 DNA replication helicase 2 homolog (yeast); DNA2 D45370_at Hs.74120 NM_006829; adipose specific 2 D49372_s_at Hs.54460 NM_002986; small inducible cytokine A11 precursor D50495_at Hs.224397 NM_003195; transcription elongation factor A (SII), 2 D63135_at Hs.27935 NM_032646; tweety homolog 2 D64053_at Hs.198288 NM_002849; protein tyrosine phosphatase, receptor type, R isoform 1 precursor NM_130846; protein tyrosine phosphatase, receptor type, R isoform 2 D83920_at Hs.440898 NM_002003; ficolin 1 precursor D85131_s_at Hs.433881 NM_002383; MYC- associated zinc finger protein D86062_s_at Hs.413482 NM_004649; chromosome 21 open reading frame 33 D86479_at Hs.439463 NM_001129; adipocyte enhancer binding protein 1 precursor D86957_at Hs.307944 Septin 8; SEPT8 D86959_at Hs.105751 NM_014720; Ste20- related serine/threonine kinase D86976_at Hs.196914 Histocompatibility (minor) HA-1; HMHA1 D87433_at Hs.301989 NM_015136; stabilin 1 D87443_at Hs.409862 NM_014758; sorting nexin 19 D87682_at Hs.134792 AVL9 homolog (S. cerevisiase); AVL9 D89077_at Hs.75367 NM_006748; Src-like- adaptor D89377_at Hs.89404 NM_002449; msh homeo box homolog 2 D90279_s_at Hs.433695 NM_000093; alpha 1 type V collagen preproprotein HG1996-HT2044_at HG2090-HT2152_s_at HG2463-HT2559_at HG2994-HT4850_s_at HG3044-HT3742_s_at HG3187-HT3366_s_at HG3342-HT3519_s_at HG371-HT26388_s_at HG4069-HT4339_s_at HG67-HT67_f_at HG907-HT907_at J02871_s_at Hs.436317 NM_000779; cytochrome P450, family 4, subfamily B, polypeptide 1 J03040_at Hs.111779 NM_003118; secreted protein, acidic, cysteine- rich (osteonectin) J03060_at Glucosidase, beta, acid pseudogene 1; GBAP1 J03068_at Trafficking protein, kinesin binding 1; TRAK1 J03241_s_at Hs.2025 NM_003239; transforming growth factor, beta 3 J03278_at Hs.307783 NM_002609; platelet- derived growth factor receptor beta precursor J03909_at Interferon, gamma- inducible protein 30; IFI30 J03925_at Hs.172631 NM_000632; integrin alpha M precursor J04056_at Hs.88778 NM_001757; carbonyl reductase 1 J04058_at Hs.169919 NM_000126; electron transfer flavoprotein, alpha polypeptide J04093_s_at Hs.278896 NM_019075; UDP glycosyltransferase 1 family, polypeptide A10 J04130_s_at Hs.75703 NM_002984; chemokine (C-C motif) ligand 4 precursor J04152_rna1_s_at Tumor-associated calcium signal transducer 2; TACSTD2 J04162_at Hs.372679 NM_000569; Fc fragment of IgG, low affinity IIIa, receptor for (CD16) J04456_at Hs.407909 NM_002305; beta- galactosidase binding lectin precursor J05032_at Hs.32393 NM_001349; aspartyl- tRNA synthetase J05036_s_at Hs.1355 NM_001910; cathepsin E isoform a preproprotein NM_148964; cathepsin E isoform b preproprotein J05070_at Hs.151738 NM_004994; matrix metalloproteinase 9 preproprotein J05448_at Hs.79402 NM_002694; DNA directed RNA polymerase II polypeptide C NM_032940; DNA directed RNA polymerase II polypeptide C K01396_at Hs.297681 NM_000295; serine (or cysteine) proteinase inhibitor, clade A (alpha-1 antiproteinase, antitrypsin), member 1 K03430_at Complement component 1, q subcomponent, B chain; C1QB L06797_s_at Hs.421986 NM_003467; chemokine (C—X—C motif) receptor 4 L10343_at Hs.112341 NM_002638; skin-derived protease inhibitor 3 preproprotein L11708_at Hs.155109 NM_002153; hydroxysteroid (17-beta) dehydrogenase 2 L13391_at Hs.78944 NM_002923; regulator of G-protein signalling 2, 24 kDa L13698_at Hs.65029 NM_002048; growth arrest-specific 1 L13720_at Hs.437710 NM_000820; growth arrest-specific 6 L13923_at Hs.750 NM_000138; fibrillin 1 AB000220_at Hs.171921 NM_006379; semaphorin 3C AC002073_cds1_at Phosphoinositide-3-kinase interacting protein 1; PIK3IP1 AF000231_at Hs.75618 NM_004663; Ras-related protein Rab-11A D10922_s_at Hs.99855 NM_001462; formyl peptide receptor-like 1 D10925_at Hs.301921 NM_001295; chemokine (C-C motif) receptor 1 D11086_at Hs.84 NM_000206; interleukin 2 receptor, gamma chain, precursor D11151_at Hs.211202 NM_001957; endothelin receptor type A D13435_at Hs.426142 NM_002643; phosphatidylinositol glycan, class F isoform 1 NM_173074; phosphatidylinositol glycan, class F isoform 2 D13666_s_at Hs.136348 NM_006475; osteoblast specific factor 2 (fasciclin I-like) D14520_at Hs.84728 NM_001730; Kruppel-like factor 5 D21878_at Hs.169998 NM_004334; bone marrow stromal cell antigen 1 precursor D26443_at Hs.371369 NM_004172; solute carrier family 1 (glial high affinity glutamate transporter), member 3 D28589_at Hs.17719 KIAA0114 D42046_at Hs.194665 D45370_at Hs.74120 NM_006829; adipose specific 2 D49372_s_at Hs.54460 NM_002986; small inducible cytokine A11 precursor D50495_at Hs.224397 NM_003195; transcription elongation factor A (SII), 2 D63135_at Hs.27935 NM_032646; tweety homolog 2 D64053_at Hs.198288 NM_002849; protein tyrosine phosphatase, receptor type, R isoform 1 precursor NM_130846; protein tyrosine phosphatase, receptor type, R isoform 2 D83920_at Hs.440898 NM_002003; ficolin 1 precursor D85131_s_at Hs.433881 NM_002383; MYC- associated zinc finger protein D86062_s_at Hs.413482 NM_004649; chromosome 21 open reading frame 33 D86479_at Hs.439463 NM_001129; adipocyte enhancer binding protein 1 precursor D86957_at Hs.307944 D86959_at Hs.105751 NM_014720; Ste20- related serine/threonine kinase D86976_at Hs.196914 D87433_at Hs.301989 NM_015136; stabilin 1 D87443_at Hs.409862 NM_014758; sorting nexin 19 D87682_at Hs.134792 D89077_at Hs.75367 NM_006748; Src-like- adaptor D89377_at Hs.89404 NM_002449; msh homeo box homolog 2 D90279_s_at Hs.433695 NM_000093; alpha 1 type V collagen preproprotein HG1996-HT2044_at HG2090-HT2152_s_at HG2463-HT2559_at HG2994-HT4850_s_at HG3044-HT3742_s_at HG3187-HT3366_s_at HG3342-HT3519_s_at HG371-HT26388_s_at HG4069-HT4339_s_at HG67-HT67_f_at HG907-HT907_at J02871_s_at Hs.436317 NM_000779; cytochrome P450, family 4, subfamily B, polypeptide 1 J03040_at Hs.111779 NM_003118; secreted protein, acidic, cysteine- rich (osteonectin) J03060_at J03068_at J03241_s_at Hs.2025 NM_003239; transforming growth factor, beta 3 J03278_at Hs.307783 NM_002609; platelet- derived growth factor receptor beta precursor J03909_at J03925_at Hs.172631 NM_000632; integrin alpha M precursor J04056_at Hs.88778 NM_001757; carbonyl reductase 1 J04058_at Hs.169919 NM_000126; electron transfer flavoprotein, alpha polypeptide J04093_s_at Hs.278896 NM_019075; UDP glycosyltransferase 1 family, polypeptide A10 J04130_s_at Hs.75703 NM_002984; chemokine (C-C motif) ligand 4 precursor J04152_rna1_s_at J04162_at Hs.372679 NM_000569; Fc fragment of IgG, low affinity IIIa, receptor for (CD16) J04456_at Hs.407909 NM_002305; beta- galactosidase binding lectin precursor J05032_at Hs.32393 NM_001349; aspartyl- tRNA synthetase J05036_s_at Hs.1355 NM_001910; cathepsin E isoform a preproprotein NM_148964; cathepsin E isoform b preproprotein J05070_at Hs.151738 NM_004994; matrix metalloproteinase 9 preproprotein J05448_at Hs.79402 NM_002694; DNA directed RNA polymerase II polypeptide C NM_032940; DNA directed RNA polymerase II polypeptide C K01396_at Hs.297681 NM_000295; serine (or cysteine) proteinase inhibitor, clade A (alpha-1 antiproteinase, antitrypsin), member 1 K03430_at L06797_s_at Hs.421986 NM_003467; chemokine (C—X—C motif) receptor 4 L10343_at Hs.112341 NM_002638; skin-derived protease inhibitor 3 preproprotein L11708_at Hs.155109 NM_002153; hydroxysteroid (17-beta) dehydrogenase 2 L13391_at Hs.78944 NM_002923; regulator of G-protein signalling 2, 24 kDa L13698_at Hs.65029 NM_002048; growth arrest-specific 1 L13720_at Hs.437710 NM_000820; growth arrest-specific 6 L13923_at Hs.750 NM_000138; fibrillin 1 AB000220_at Hs.171921 NM_006379; semaphorin 3C AC002073_cds1_at AF000231_at Hs.75618 NM_004663; Ras-related protein Rab-11A D10922_s_at Hs.99855 NM_001462; formyl peptide receptor-like 1 D10925_at Hs.301921 NM_001295; chemokine (C-C motif) receptor 1 D11086_at Hs.84 NM_000206; interleukin 2 receptor, gamma chain, precursor D11151_at Hs.211202 NM_001957; endothelin receptor type A D13435_at Hs.426142 NM_002643; phosphatidylinositol glycan, class F isoform 1 NM_173074; phosphatidylinositol glycan, class F isoform 2 D13666_s_at Hs.136348 NM_006475; osteoblast specific factor 2 (fasciclin I-like) D14520_at Hs.84728 NM_001730; Kruppel-like factor 5 D21878_at Hs.169998 NM_004334; bone marrow stromal cell antigen 1 precursor D26443_at Hs.371369 NM_004172; solute carrier family 1 (glial high affinity glutamate transporter), member 3 D28589_at Hs.17719 D42046_at Hs.194665 D45370_at Hs.74120 NM_006829; adipose specific 2 D49372_s_at Hs.54460 NM_002986; small inducible cytokine A11 precursor D50495_at Hs.224397 NM_003195; transcription elongation factor A (SII), 2 D63135_at Hs.27935 NM_032646; tweety homolog 2 D64053_at Hs.198288 NM_002849; protein tyrosine phosphatase, receptor type, R isoform 1 precursor NM_130846; protein tyrosine phosphatase, receptor type, R isoform 2 D83920_at Hs.440898 NM_002003; ficolin 1 precursor D85131_s_at Hs.433881 NM_002383; MYC- associated zinc finger protein D86062_s_at Hs.413482 NM_004649; chromosome 21 open reading frame 33 D86479_at Hs.439463 NM_001129; adipocyte enhancer binding protein 1 precursor D86957_at Hs.307944 D86959_at Hs.105751 NM_014720; Ste20- related serine/threonine kinase D86976_at Hs.196914 D87433_at Hs.301989 NM_015136; stabilin 1 D87443_at Hs.409862 NM_014758; sorting nexin 19 D87682_at Hs.134792 D89077_at Hs.75367 NM_006748; Src-like- adaptor D89377_at Hs.89404 NM_002449; msh homeo box homolog 2 D90279_s_at Hs.433695 NM_000093; alpha 1 type V collagen preproprotein HG1996-HT2044_at HG2090-HT2152_s_at HG2463-HT2559_at HG2994-HT4850_s_at HG3044-HT3742_s_at HG3187-HT3366_s_at HG3342-HT3519_s_at HG371-HT26388_s_at HG4069-HT4339_s_at HG67-HT67_f_at HG907-HT907_at J02871_s_at Hs.436317 NM_000779; cytochrome P450, family 4, subfamily B, polypeptide 1 J03040_at Hs.111779 NM_003118; secreted protein, acidic, cysteine- rich (osteonectin) J03060_at J03068_at J03241_s_at Hs.2025 NM_003239; transforming growth factor, beta 3 J03278_at Hs.307783 NM_002609; platelet- derived growth factor receptor beta precursor J03909_at J03925_at Hs.172631 NM_000632; integrin alpha M precursor J04056_at Hs.88778 NM_001757; carbonyl reductase 1 J04058_at Hs.169919 NM_000126; electron transfer flavoprotein, alpha polypeptide J04093_s_at Hs.278896 NM_019075; UDP glycosyltransferase 1 family, polypeptide A10 J04130_s_at Hs.75703 NM_002984; chemokine (C-C motif) ligand 4 precursor J04152_rna1_s_at J04162_at Hs.372679 NM_000569; Fc fragment of IgG, low affinity IIIa, receptor for (CD16) J04456_at Hs.407909 NM_002305; beta- galactosidase binding lectin precursor J05032_at Hs.32393 NM_001349; aspartyl- tRNA synthetase J05036_s_at Hs.1355 NM_001910; cathepsin E isoform a preproprotein NM_148964; cathepsin E isoform b preproprotein J05070_at Hs.151738 NM_004994; matrix metalloproteinase 9 preproprotein J05448_at Hs.79402 NM_002694; DNA directed RNA polymerase II polypeptide C NM_032940; DNA directed RNA polymerase II polypeptide C K01396_at Hs.297681 NM_000295; serine (or cysteine) proteinase inhibitor, clade A (alpha-1 antiproteinase, antitrypsin), member 1 K03430_at L06797_s_at Hs.421986 NM_003467; chemokine (C—X—C motif) receptor 4 L10343_at Hs.112341 NM_002638; skin-derived protease inhibitor 3 preproprotein L11708_at Hs.155109 NM_002153; hydroxysteroid (17-beta) dehydrogenase 2 L13391_at Hs.78944 NM_002923; regulator of G-protein signalling 2, 24 kDa L13698_at Hs.65029 NM_002048; growth arrest-specific 1 L13720_at Hs.437710 NM_000820; growth arrest-specific 6 L13923_at Hs.750 NM_000138; fibrillin 1 AB000220_at Hs.171921 NM_006379; semaphorin 3C AC002073_cds1_at AF000231_at Hs.75618 NM_004663; Ras-related protein Rab-11A D10922_s_at Hs.99855 NM_001462; formyl peptide receptor-like 1 D10925_at Hs.301921 NM_001295; chemokine (C-C motif) receptor 1 D11086_at Hs.84 NM_000206; interleukin 2 receptor, gamma chain, precursor D11151_at Hs.211202 NM_001957; endothelin receptor type A D13435_at Hs.426142 NM_002643; phosphatidylinositol glycan, class F isoform 1 NM_173074; phosphatidylinositol glycan, class F isoform 2 D13666_s_at Hs.136348 NM_006475; osteoblast specific factor 2 (fasciclin I-like) D14520_at Hs.84728 NM_001730; Kruppel-like factor 5 D21878_at Hs.169998 NM_004334; bone marrow stromal cell antigen 1 precursor D26443_at Hs.371369 NM_004172; solute carrier family 1 (glial high affinity glutamate transporter), member 3 D28589_at Hs.17719 D42046_at Hs.194665 D45370_at Hs.74120 NM_006829; adipose specific 2 D49372_s_at Hs.54460 NM_002986; small inducible cytokine A11 precursor D50495_at Hs.224397 NM_003195; transcription elongation factor A (SII), 2 D63135_at Hs.27935 NM_032646; tweety homolog 2 D64053_at Hs.198288 NM_002849; protein tyrosine phosphatase, receptor type, R isoform 1 precursor NM_130846; protein tyrosine phosphatase, receptor type, R isoform 2 D83920_at Hs.440898 NM_002003; ficolin 1 precursor D85131_s_at Hs.433881 NM_002383; MYC- associated zinc finger protein D86062_s_at Hs.413482 NM_004649; chromosome 21 open reading frame 33 D86479_at Hs.439463 NM_001129; adipocyte enhancer binding protein 1 precursor D86957_at Hs.307944 D86959_at Hs.105751 NM_014720; Ste20- related serine/threonine kinase D86976_at Hs.196914 D87433_at Hs.301989 NM_015136; stabilin 1 D87443_at Hs.409862 NM_014758; sorting nexin 19 D87682_at Hs.134792 D89077_at Hs.75367 NM_006748; Src-like- adaptor D89377_at Hs.89404 NM_002449; msh homeo box homolog 2 D90279_s_at Hs.433695 NM_000093; alpha 1 type V collagen preproprotein HG1996-HT2044_at HG2090-HT2152_s_at HG2463-HT2559_at HG2994-HT4850_s_at HG3044-HT3742_s_at HG3187-HT3366_s_at HG3342-HT3519_s_at HG371-HT26388_s_at HG4069-HT4339_s_at HG67-HT67_f_at HG907-HT907_at J02871_s_at Hs.436317 NM_000779; cytochrome P450, family 4, subfamily B, polypeptide 1 J03040_at Hs.111779 NM_003118; secreted protein, acidic, cysteine- rich (osteonectin) J03060_at J03068_at J03241_s_at Hs.2025 NM_003239; transforming growth factor, beta 3 J03278_at Hs.307783 NM_002609; platelet- derived growth factor receptor beta precursor J03909_at J03925_at Hs.172631 NM_000632; integrin alpha M precursor J04056_at Hs.88778 NM_001757; carbonyl reductase 1 J04058_at Hs.169919 NM_000126; electron transfer flavoprotein, alpha polypeptide J04093_s_at Hs.278896 NM_019075; UDP glycosyltransferase 1 family, polypeptide A10 J04130_s_at Hs.75703 NM_002984; chemokine (C-C motif) ligand 4 precursor J04152_rna1_s_at J04162_at Hs.372679 NM_000569; Fc fragment of IgG, low affinity IIIa, receptor for (CD16) J04456_at Hs.407909 NM_002305; beta- galactosidase binding lectin precursor J05032_at Hs.32393 NM_001349; aspartyl- tRNA synthetase J05036_s_at Hs.1355 NM_001910; cathepsin E isoform a preproprotein NM_148964; cathepsin E isoform b preproprotein J05070_at Hs.151738 NM_004994; matrix metalloproteinase 9 preproprotein J05448_at Hs.79402 NM_002694; DNA directed RNA polymerase II polypeptide C NM_032940; DNA directed RNA polymerase II polypeptide C K01396_at Hs.297681 NM_000295; serine (or cysteine) proteinase inhibitor, clade A (alpha-1 antiproteinase, antitrypsin), member 1 K03430_at L06797_s_at Hs.421986 NM_003467; chemokine (C—X—C motif) receptor 4 L10343_at Hs.112341 NM_002638; skin-derived protease inhibitor 3 preproprotein L11708_at Hs.155109 NM_002153; hydroxysteroid (17-beta) dehydrogenase 2 L13391_at Hs.78944 NM_002923; regulator of G-protein signalling 2, 24 kDa L13698_at Hs.65029 NM_002048; growth arrest-specific 1 L13720_at Hs.437710 NM_000820; growth arrest-specific 6 L13923_at Hs.750 NM_000138; fibrillin 1 AB000220_at Hs.171921 NM_006379; semaphorin 3C AC002073_cds1_at AF000231_at Hs.75618 NM_004663; Ras-related protein Rab-11A D10922_s_at Hs.99855 NM_001462; formyl peptide receptor-like 1 D10925_at Hs.301921 NM_001295; chemokine (C-C motif) receptor 1 D11086_at Hs.84 NM_000206; interleukin 2 receptor, gamma chain, precursor D11151_at Hs.211202 NM_001957; endothelin receptor type A D13435_at Hs.426142 NM_002643; phosphatidylinositol glycan, class F isoform 1 NM_173074; phosphatidylinositol glycan, class F isoform 2 D13666_s_at Hs.136348 NM_006475; osteoblast specific factor 2 (fasciclin I-like) D14520_at Hs.84728 NM_001730; Kruppel-like factor 5 D21878_at Hs.169998 NM_004334; bone marrow stromal cell antigen 1 precursor D26443_at Hs.371369 NM_004172; solute carrier family 1 (glial high affinity glutamate transporter), member 3 D28589_at Hs.17719 D42046_at Hs.194665 D45370_at Hs.74120 NM_006829; adipose specific 2 D49372_s_at Hs.54460 NM_002986; small inducible cytokine A11 precursor D50495_at Hs.224397 NM_003195; transcription elongation factor A (SII), 2 D63135_at Hs.27935 NM_032646; tweety homolog 2 D64053_at Hs.198288 NM_002849; protein tyrosine phosphatase, receptor type, R isoform 1 precursor NM_130846; protein tyrosine phosphatase, receptor type, R isoform 2 D83920_at Hs.440898 NM_002003; ficolin 1 precursor D85131_s_at Hs.433881 NM_002383; MYC- associated zinc finger protein D86062_s_at Hs.413482 NM_004649; chromosome 21 open reading frame 33 D86479_at Hs.439463 NM_001129; adipocyte enhancer binding protein 1 precursor D86957_at Hs.307944 D86959_at Hs.105751 NM_014720; Ste20- related serine/threonine kinase D86976_at Hs.196914 D87433_at Hs.301989 NM_015136; stabilin 1 D87443_at Hs.409862 NM_014758; sorting nexin 19 D87682_at Hs.134792 D89077_at Hs.75367 NM_006748; Src-like- adaptor D89377_at Hs.89404 NM_002449; msh homeo box homolog 2 D90279_s_at Hs.433695 NM_000093; alpha 1 type V collagen preproprotein HG1996-HT2044_at HG2090-HT2152_s_at HG2463-HT2559_at HG2994-HT4850_s_at

TABLE 10 160 Genes for classifier UniGene Build Chip acc. # 162 Description AF000231_at Hs.75618 NM_004663; Ras-related protein Rab-11A D13666_s_at Hs.136348 NM_006475; osteoblast specific factor 2 (fasciclin I-like) D21878_at Hs.169998 NM_004334; bone marrow stromal cell antigen 1 precursor D45370_at Hs.74120 NM_006829; adipose specific 2 D49372_s_at Hs.54460 NM_002986; small inducible cytokine A11 precursor D83920_at Hs.440898 NM_002003; ficolin 1 precursor D85131_s_at Hs.433881 NM_002383; MYC-associated zinc finger protein D86062_s_at Hs.413482 NM_004649; chromosome 21 open reading frame 33 D86479_at Hs.439463 NM_001129; adipocyte enhancer binding protein 1 precursor D86957_at Hs.307944 Septin 8; SEPT 8 D86976_at Hs.196914 Histocompatibility (minor) HA-1; HMHA1 D87433_at Hs.301989 NM_015136; stabilin 1 D89077_at Hs.75367 NM_006748; Src-like-adaptor D89377_at Hs.89404 NM_002449; msh homeo box homolog 2 HG3044-HT3742_s_at HG371-HT26388_s_at HG4069-HT4339_s_at HG67-HT67_f_at HG907-HT907_at J02871_s_at Hs.436317 NM_000779; cytochrome P450, family 4, subfamily B, polypeptide 1 J03040_at Hs.111779 NM_003118; secreted protein, acidic, cysteine-rich (osteonectin) J03068_at Trafficking protein, kinesin binding 1; TRAK1 J03241_s_at Hs.2025 NM_003239; transforming growth factor, beta 3 J03278_at Hs.307783 NM_002609; platelet-derived growth factor receptor beta precursor J03909_at Interferon, gamma-inducible protein 30; IFI30 J04058_at Hs.169919 NM_000126; electron transfer flavoprotein, alpha polypeptide J04130_s_at Hs.75703 NM_002984; chemokine (C-C motif) ligand 4 precursor J04162_at Hs.372679 NM_000569; Fc fragment of IgG, low affinity IIIa, receptor for (CD16) J04456_at Hs.407909 NM_002305; beta-galactosidase binding lectin precursor J05032_at Hs.32393 NM_001349; aspartyl-tRNA synthetase J05070_at Hs.151738 NM_004994; matrix metalloproteinase 9 preproprotein J05448_at Hs.79402 NM_002694; DNA directed RNA polymerase II polypeptide C NM_032940; DNA directed RNA polymerase II polypeptide C K01396_at Hs.297681 NM_000295; serine (or cysteine) proteinase inhibitor, clade A (alpha-1 antiproteinase, antitrypsin), member 1 K03430_at Complement component1, q subcomponent, B chain; C1QB L13698_at Hs.65029 NM_002048; growth arrest-specific 1 L13720_at Hs.437710 NM_000820; growth arrest-specific 6 L13923_at Hs.750 NM_000138; fibrillin 1 L15409_at Hs.421597 NM_000551; elogin binding protein L17325_at Hs.195825 NM_006867; RNA-binding protein with multiple splicing L19872_at Hs.170087 NM_001621; aryl hydrocarbon receptor L27476_at Hs.75608 NM_004817; tight junction protein 2 (zona occludens 2) L33799_at Hs.202097 NM_002593; procollagen C-endopeptidase enhancer L40388_at Hs.30212 NM_004236; thyroid receptor interacting protein 15 L40904_at Hs.387667 NM_005037; peroxisome proliferative activated receptor gamma isoform 1 NM_015869; peroxisome proliferative activated receptor gamma isoform 2 NM_138711; peroxisome proliferative activated receptor gamma isoform 1 NM_138712; peroxisome proliferative activated receptor gamma isoform 1 L41919_rna1_at Hypermethylated in cancer 1; HIC1 M11433_at Hs.101850 NM_002899; retinol binding protein 1, cellular M11718_at Hs.283393 NM_000393; alpha 2 type V collagen preproprotein M12125_at Hs.300772 NM_003289; tropomyosin 2 (beta) M14218_at Hs.442047 NM_000048; argininosuccinate lyase M15395_at Hs.375957 NM_000211; integrin beta chain, beta 2 precursor M16591_s_at Hs.89555 NM_002110; hemopoietic cell kinase isoform p61HCK M17219_at Hs.203862 NM_002069; guanine nucleotide binding protein (G protein), alpha inhibiting activity polypeptide 1 M20530_at Serine peptidase inhibitor, Kazal type 1; SPINK1 M23178_s_at Hs.73817 NM_002983; chemokine (C-C motif) ligand 3 M28130_rna1_s_at Interleukin 8; IL8 M29550_at Hs.187543 NM_021132; protein phosphatase 3 (formerly 2B), catalytic subunit, beta isoform (calcineurin A beta) M31165_at Hs.407546 NM_007115; tumor necrosis factor, alpha-induced protein 6 precursor M32011_at Hs.949 NM_000433; neutrophil cytosolic factor 2 M33195_at Hs.433300 NM_004106; Fc fragment of IgE, high affinity I, receptor for, gamma polypeptide precursor M37033_at Hs.443057 NM_000560; CD53 antigen M37766_at Hs.901 NM_001778; CD48 antigen (B-cell membrane protein) M55998_s_at Hs.172928 NM_000088; alpha 1 type I collagen preproprotein M57731_s_at Hs.75765 NM_002089; chemokine (C—X—C motif) ligand 2 M62840_at Hs.82542 NM_001637; acyloxyacyl hydrolase precursor M63262_at Arachidonate 5-lipoxygenase-activating protein; ALOX5AP M68840_at Hs.183109 NM_000240; monoamine oxidase A M69203_s_at Hs.75703 NM_002984; chemokine (C-C motif) ligand 4 precursor M72885_rna1_s_at G0/G1 switch 2; G0S2 M77349_at Hs.421496 NM_000358; transforming growth factor, beta-induced, 68 kDa M82882_at Hs.124030 NM_172373; E74-like factor 1 (ets domain transcription factor) M83822_at Hs.209846 NM_006726; LPS-responsive vesicle trafficking, beach and anchor containing M92934_at Hs.410037 NM_001901; connective tissue growth factor M95178_at Hs.119000 NM_001102; actinin, alpha 1 S69115_at Hs.10306 NM_005601; natural killer cell group 7 sequence S77393_at Hs.145754 NM_016531; Kruppel-like factor 3 (basic) S78187_at Hs.153752 NM_004358; cell division cycle 25B isoform 1 NM_021872; cell division cycle 25B isoform 2 NM_021873; cell division cycle 25B isoform 3 NM_021874; cell division cycle 25B isoform 4 U01833_at Hs.81469 NM_002484; nucleotide binding protein 1 (MinD homolog, E. coli) U07231_at Hs.309763 NM_002092; G-rich RNA sequence binding factor 1 U09278_at Hs.436852 NM_004460; fibroblast activation protein, alpha subunit U09937_rna1_s_at Plasminogen activator, urokinase receptor CD87; PLAUR U10550_at Hs.79022 NM_005261; GTP-binding mitogen-induced T-cell protein NM_181702; GTP-binding mitogen-induced T-cell protein U12424_s_at Hs.108646 NM_000408; glycerol-3-phosphate dehydrogenase 2 (mitochondrial) U16306_at Hs.434488 NM_004385; chondroitin sulfate proteoglycan 2 (versican) U20158_at Hs.2488 NM_005565; lymphocyte cytosolic protein 2 U20536_s_at Hs.3280 NM_001226; caspase 6 isoform alpha preproprotein NM_032992; caspase 6 isoform beta U24266_at Hs.77448 NM_003748; aldehyde dehydrogenase 4A1 precursor NM_170726; aldehyde dehydrogenase 4A1 precursor U28249_at Hs.301350 NM_005971; FXYD domain containing ion transport regulator 3 isoform 1 precursor NM_021910; FXYD domain containing ion transport regulator 3 isoform 2 precursor U28488_s_at Hs.155935 NM_004054; complement component 3a receptor 1 U29680_at Hs.227817 NM_004049; BCL2-related protein A1 U37143_at Hs.152096 NM_000775; cytochrome P450, family 2, subfamily 1, polypeptide 2 U38864_at Hs.108139 NM_012256; zinc finger protein 212 U39840_at Hs.163484 NM_004496; forkhead box A1 U41315_rna1_s_at Makorin ring finger protein 1; MKRN1 U44111_at Hs.42151 NM_006895; histamine N-methyltransferase U47414_at Hs.13291 NM_004354; cyclin G2 U49352_at Hs.414754 NM_001359; 2,4-dienoyl CoA reductase 1 precursor U50708_at Hs.1265 NM_000056; branched chain keto acid dehydrogenase E1, beta polypeptide precursor NM_183050; branched chain keto acid dehydrogenase E1, beta polypeptide precursor U52101_at Hs.9999 NM_001425; epithelial membrane protein 3 U59914_at Hs.153863 NM_005585; MAD, mothers against decapentaplegic homolog 6 U60205_at Hs.393239 NM_006745; sterol-C4-methyl oxidase-like U61981_at Hs.42674 NM_002439; mutS homolog 3 U64520_at Hs.66708 NM_004781; vesicle-associated membrane protein 3 (cellubrevin) U65093_at Hs.82071 NM_006079; Cbp/p300-interacting transactivator, with Glu/Asp-rich carboxy-terminal domain, 2 U66619_at Hs.444445 NM_003078; SWI/SNF-related matrix-associated actin-dependent regulator of chromatin d3 U68019_at Hs.288261 NM_005902; MAD, mothers against decapentaplegic homolog 3 U68385_at Hs.380923 Meis homeobox 3 pseudogene 1; MEIS3P1 U68485_at Hs.193163 NM_004305; bridging integrator 1 isoform 8 NM_139343; bridging integrator 1 isoform 1 NM_139344; bridging integrator 1 isoform 2 NM_139345; bridging integrator 1 isoform 3 NM_139346; bridging integrator 1 isoform 4 NM_139347; bridging integrator 1 isoform 5 NM_139348; bridging integrator 1 isoform 6 NM_139349; bridging integrator 1 isoform 7 NM_139350; bridging integrator 1 isoform 9 NM_139351; bridging integrator 1 isoform 10 U74324_at Hs.90875 NM_002871; RAB-interacting factor U77970_at Hs.321164 NM_002518; neuronal PAS domain protein 2 NM_032235; U83303_cds2_at Hs.164021 NM_002993; chemokine (C—X—C motif) ligand 6 (granulocyte chemotactic protein 2) U88871_at Hs.79993 NM_000288; peroxisomal biogenesis factor 7 U90549_at Hs.236774 NM_006353; high mobility group nucleosomal binding domain 4 U90716_at Hs.79187 NM_001338; coxsackie virus and adenovirus receptor V00594_at Hs.118786 NM_005953; metallothionein 2A V00594_s_at Hs.118786 NM_005953; metallothionein 2A X02761_s_at Hs.418138 NM_002026; fibronectin 1 isoform 1 preproprotein NM_054034; fibronectin 1 isoform 2 preproprotein X04011_at Hs.88974 NM_000397; cytochrome b-245, beta polypeptide (chronic granulomatous disease) X04085_rna1_at Catalase; CAT X07438_s_at Retinol binding protein 1, cellular; RBP1 X07743_at Hs.77436 NM_002664; pleckstrin X13334_at Hs.75627 NM_000591; CD14 antigen precursor X14046_at Hs.153053 NM_001774; CD37 antigen X14813_at Hs.166160 NM_001607; acetyl-Coenzyme A acyltransferase 1 X15880_at Hs.415997 NM_001848; collagen, type VI, alpha 1 precursor X15882_at Hs.420269 NM_001849; alpha 2 type VI collagen isoform 2C2 precursor NM_058174; alpha 2 type VI collagen isoform 2C2a precursor NM_058175; alpha 2 type VI collagen isoform 2C2a precursor X51408_at Hs.380138 NM_001822; chimerin (chimaerin) 1 X53800_s_at Hs.89690 NM_002090; chemokine (C—X—C motif) ligand 3 X54489_rna1_at Chemokine (C—X—C motif) ligand 1 (melanoma growth stimulating activity, alpha); CXCL1 X57351_s_at Hs.174195 NM_006435; interferon induced transmembrane protein 2 (1-8D) X57579_s_at Inhibin, beta A; INHBA X58072_at Hs.169946 NM_002051; GATA binding protein 3 NM_032742; X62048_at Hs.249441 NM_003390; wee1 tyrosine kinase X64072_s_at Hs.375957 NM_000211; integrin beta chain, beta 2 precursor X65614_at Hs.2962 NM_005980; S100 calcium binding protein P X66945_at Hs.748 NM_000604; fibroblast growth factor receptor 1 isoform 1 precursor NM_015850; fibroblast growth factor receptor 1 isoform 2 precursor NM_023105; fibroblast growth factor receptor 1 isoform 3 precursor NM_023106; fibroblast growth factor receptor 1 isoform 4 precursor NM_023107; fibroblast growth factor receptor 1 isoform 5 precursor NM_023108; fibroblast growth factor receptor 1 isoform 6 precursor NM_023109; fibroblast growth factor receptor 1 isoform 7 precursor NM_023110; fibroblast growth factor receptor 1 isoform 8 precursor NM_023111; fibroblast growth factor receptor 1 isoform 9 precursor X67491_f_at Hs.355697 NM_005271; glutamate dehydrogenase 1 X68194_at Hs.80919 NM_006754; synaptophysin-like protein isoform a NM_182715; synaptophysin-like protein isoform b X73882_at Hs.254605 NM_003980; microtubule-associated protein 7 X78520_at Hs.372528 NM_001829; chloride channel 3 X78549_at Hs.51133 NM_005975; PTK6 protein tyrosine kinase 6 X78565_at Hs.98998 NM_002160; tenascin C (hexabrachion) AF000231_at Hs.75618 NM_004663; Ras-related protein Rab-11A D13666_s_at Hs.136348 NM_006475; osteoblast specific factor 2 (fasciclin I-like) D49372_s_at Hs.54460 NM_002986; small inducible cytokine A11 precursor D83920_at Hs.440898 NM_002003; ficolin 1 precursor D86479_at Hs.439463 NM_001129; adipocyte enhancer binding protein 1 precursor D87433_at Hs.301989 NM_015136; stabilin 1 D89077_at Hs.75367 NM_006748; Src-like-adaptor D89377_at Hs.89404 NM_002449; msh homeo box homolog 2 HG4069-HT4339_s_at HG67-HT67_f_at HG907-HT907_at J02871_s_at Hs.436317 NM_000779; cytochrome P450, family 4, subfamily B, polypeptide 1 J03278_at Hs.307783 NM_002609; platelet-derived growth factor receptor beta precursor J04058_at Hs.169919 NM_000126; electron transfer flavoprotein, alpha polypeptide J05032_at Hs.32393 NM_001349; aspartyl-tRNA synthetase J05070_at Hs.151738 NM_004994; matrix metalloproteinase 9 preproprotein J05448_at Hs.79402 NM_002694; DNA directed RNA polymerase II polypeptide C NM_032940; DNA directed RNA polymerase II polypeptide C K01396_at Hs.297681 NM_000295; serine (or cysteine) proteinase inhibitor, clade A (alpha-1 antiproteinase, antitrypsin), member 1 L13720_at Hs.437710 NM_000820; growth arrest-specific 6 L40904_at Hs.387667 NM_005037; peroxisome proliferative activated receptor gamma isoform 1 NM_015869; peroxisome proliferative activated receptor gamma isoform 2 NM_138711; peroxisome proliferative activated receptor gamma isoform 1 NM_138712; peroxisome proliferative activated receptor gamma isoform 1 M12125_at Hs.300772 NM_003289; tropomyosin 2 (beta) M15395_at Hs.375957 NM_000211; integrin beta chain, beta 2 precursor M16591_s_at Hs.89555 NM_002110; hemopoietic cell kinase isoform p61HCK M20530_at M23178_s_at Hs.73817 NM_002983; chemokine (C-C motif) ligand 3 M32011_at Hs.949 NM_000433; neutrophil cytosolic factor 2 M33195_at Hs.433300 NM_004106; Fc fragment of IgE, high affinity I, receptor for, gamma polypeptide precursor M55998_s_at Hs.172928 NM_000088; alpha 1 type I collagen preproprotein M57731_s_at Hs.75765 NM_002089; chemokine (C—X—C motif) ligand 2 M63262_at M68840_at Hs.183109 NM_000240; monoamine oxidase A M69203_s_at Hs.75703 NM_002984; chemokine (C-C motif) ligand 4 precursor M72885_rna1_s_at G0/G1 switch 2; G0S2 M83822_at Hs.209846 NM_006726; LPS-responsive vesicle trafficking, beach and anchor containing S77393_at Hs.145754 NM_016531; Kruppel-like factor 3 (basic) U01833_at Hs.81469 NM_002484; nucleotide binding protein 1 (MinD homolog, E. coli) U07231_at Hs.309763 NM_002092; G-rich RNA sequence binding factor 1 U09937_rna1_s_at Plasminogen activator, urokinase receptor CD87; PLAUR U10550_at Hs.79022 NM_005261; GTP-binding mitogen-induced T-cell protein NM_181702; GTP-binding mitogen-Induced T-cell protein U20158_at Hs.2488 NM_005565; lymphocyte cytosolic protein 2 U28488_s_at Hs.155935 NM_004054; complement component 3a receptor 1 U29680_at Hs.227817 NM_004049; BCL2-related protein A1 U41315_rna1_s_at Makorin ring finger protein 1; MKRN1 U47414_at Hs.13291 NM_004354; cyclin G2 U49352_at Hs.414754 NM_001359; 2,4-dienoyl CoA reductase 1 precursor U50708_at Hs.1265 NM_000056; branched chain keto acid dehydrogenase E1, beta polypeptide precursor NM_183050; branched chain keto acid dehydrogenase E1, beta polypeptide precursor U52101_at Hs.9999 NM_001425; epithelial membrane protein 3 U59914_at Hs.153863 NM_005585; MAD, mothers against decapentaplegic homolog 6 U64520_at Hs.66708 NM_004781; vesicle-associated membrane protein 3 (cellubrevin) U65093_at Hs.82071 NM_006079; Cbp/p300-interacting transactivator, with Glu/Asp-rich carboxy-terminal domain, 2 U68019_at Hs.288261 NM_005902; MAD, mothers against decapentaplegic homolog 3 U68385_at Hs.380923 Meis homeobox 3 pseudogene 1; MEIS3P1 U74324_at Hs.90875 NM_002871; RAB-interacting factor U77970_at Hs.321164 NM_002518; neuronal PAS domain protein 2 NM_032235; U90549_at Hs.236774 NM_006353; high mobility group nucleosomal binding domain 4 X04085_rna1_at Catalase; CAT X07438_s_at Retinol binding protein 1, cellular; RBP1 X07743_at Hs.77436 NM_002664; pleckstrin X13334_at Hs.75627 NM_000591; CD14 antigen precursor X14046_at Hs.153053 NM_001774; CD37 antigen X15880_at Hs.415997 NM_001848; collagen, type VI, alpha 1 precursor X15882_at Hs.420269 NM_001849; alpha 2 type VI collagen isoform 2C2 precursor NM_058174; alpha 2 type VI collagen isoform 2C2a precursor NM_058175; alpha 2 type VI collagen isoform 2C2a precursor X51408_at Hs.380138 NM_001822; chimerin (chimaerin) 1 X53800_s_at Hs.89690 NM_002090; chemokine (C—X—C motif) ligand 3 X54489_rna1_at chemokine (C—X—C motif) ligand 1 (melanoma growth stimulating activity, alpha); CXCL1 X57579_s_at Inhibin, beta A; INHBA X62048_at Hs.249441 NM_003390; wee1 tyrosine kinase X64072_s_at Hs.375957 NM_000211; integrin beta chain, beta 2 precursor X67491_f_at Hs.355697 NM_005271; glutamate dehydrogenase 1 X68194_at Hs.80919 NM_006754; synaptophysin-like protein isoform a NM_182715; synaptophysin-like protein isoform b X73882_at Hs.254605 NM_003980; microtubule-associated protein 7 X78520_at Hs.372528 NM_001829; chloride channel 3 X97267_rna1_s_at Protein tyrosine phosphatase, receptor type, C-associated protein; PTPRCAP Y00787_s_at Hs.624 NM_000584; interleukin 8 precursor Z12173_at Hs.334534 NM_002076; glucosamine (N-acetyl)-6-sulfatase precursor Z19554_s_at Hs.435800 NM_003380; vimentin Z26491_s_at Hs.240013 NM_000754; catechol-O-methyltransferase isoform MB-COMT NM_007310; catechol-O-methyltransferase isoform S-COMT Z29331_at Hs.372758 NM_003344; ubiquitin-conjugating enzyme E2H isoform 1 NM_182697; ubiquitin-conjugating enzyme E2H isoform 2 Z48605_at Hs.421825 NM_006903; inorganic pyrophosphatase 2 isoform 2 NM_176865; NM_176866; inorganic pyrophosphatase 2 isoform 3 NM_176867; inorganic pyrophosphatase 2 isoform 4 NM_176869; inorganic pyrophosphatase 2 isoform 1 Z74615_at Hs.172928 NM_000088; alpha 1 type I collagen preproprotein

TABLE 12 40 genes for classifier UniGene Chip acc. # Build 162 description D83920_at Hs.440898 NM_002003; ficolin 1 precursor D89377_at Hs.89404 NM_002449; msh homeo box homolog 2 J02871_s_at Hs.436317 NM_000779; cytochrome P450, family 4, subfamily B, polypeptide 1 J05032_at Hs.32393 NM_001349; aspartyl-tRNA synthetase J05070_at Hs.151738 NM_004994; matrix metalloproteinase 9 preproprotein M16591_s_at Hs.89555 NM_002110; hemopoietic cell kinase isoform p61HCK M23178_s_at Hs.73817 NM_002983; chemokine (C-C motif) ligand 3 M32011_at Hs.949 NM_000433; neutrophil cytosolic factor 2 M33195_at Hs.433300 NM_004106; Fc fragment of IgE, high affinity I, receptor for, gamma polypeptide precursor M57731_s_at Hs.75765 NM_002089; chemokine (C-X-C motif) ligand 2 M68840_at Hs.183109 NM_000240; monoamine oxidase A M69203_s_at Hs.75703 NM_002984; chemokine (C-C motif) ligand 4 precursor S77393_at Hs.145754 NM_016531; Kruppel-like factor 3 (basic) U01833_at Hs.81469 NM_002484; nucleotide binding protein 1 (MinD homolog, E. coli) U07231_at Hs.309763 NM_002092; G-rich RNA sequence binding factor 1 U09937_rna1_s_at Plasminogen activator, urokinase receptor CD87; PLAUR U20158_at Hs.2488 NM_005565; lymphocyte cytosolic protein 2 U41315_rna1_s_at Makorin ring finger protein 1; MKRN1 U47414_at Hs.13291 NM_004354; cyclin G2 U49352_at Hs.414754 NM_001359; 2,4-dienoyl CoA reductase 1 precursor U50708_at Hs.1265 NM_000056; branched chain keto acid dehydrogenase E1, beta polypeptide precursor NM_183050; branched chain keto acid dehydrogenase E1, beta polypeptide precursor U65093_at Hs.82071 NM_006079; Cbp/p300-interacting transactivator, with Glu/Asp-rich carboxy-terminal domain, 2 U68385_at Hs.380923 Meis homeobox 3 pseudogene 1; MEISP1 U77970_at Hs.321164 NM_002518; neuronal PAS domain protein 2 NM_032235; U90549_at Hs.236774 NM_006353; high mobility group nucleosomal binding domain 4 X13334_at Hs.75627 NM_000591; CD14 antigen precursor X15880_at Hs.415997 NM_001848; collagen, type VI, alpha 1 precursor X15882_at Hs.420269 NM_001849; alpha 2 type VI collagen isoform 2C2 precursor NM_058174; alpha 2 type VI collagen isoform 2C2a precursor NM_058175; alpha 2 type VI collagen isoform 2C2a precursor X51408_at Hs.380138 NM_001822; chimerin (chimaerin) 1 X53800_s_at Hs.89690 NM_002090; chemokine (C-X-C motif) ligand 3 X54489_rna1_at Chemokine (C-X-C motif) ligand 1 (melanoma growth stimulating activity, alpha): CXCL1 X57579_s_at Inhibin, beta A; INHBA X64072_s_at Hs.375957 NM_000211; integrin beta chain, beta 2 precursor X67491_f_at Hs.355697 NM_005271; glutamate dehydrogenase 1 X68194_at Hs.80919 NM_006754; synaptophysin-like protein isoform a NM_182715; synaptophysin-like protein isoform b X73882_at Hs.254605 NM_003980; microtubule-associated protein 7 X78520_at Hs.372528 NM_001829; chloride channel 3 Z29331_at Hs.372758 NM_003344; ubiquitin-conjugating enzyme E2H isoform 1 NM_182697; ubiquitin-conjugating enzyme E2H isoform 2 Z48605_at Hs.421825 NM_006903; inorganic pyrophosphatase 2 isoform 2 NM_176865; NM_176866; inorganic pyrophosphatase 2 isoform 3 NM_176867; inorganic pyrophosphatase 2 isoform 4 NM_176869; inorganic pyrophosphatase 2 isoform 1 Z74615_at Hs.172928 NM_000088; alpha 1 type I collagen preproprotein

TABLE 13 20 genes for classifier UniGene Chip acc. # Build 162 description D89377_at Hs.89404 NM_002449; msh homeo box homolog 2 J05032_at Hs.32393 NM_001349; aspartyl-tRNA synthetase M23178_s_at Hs.73817 NM_002983; chemokine (C-C motif) ligand 3 M32011_at Hs.949 NM_000433; neutrophil cytosolic factor 2 M69203_s_at Hs.75703 NM_002984; chemokine (C-C motif) ligand 4 precursor S77393_at Hs.145754 NM_016531; Kruppel-like factor 3 (basic) U07231_at Hs.309763 NM_002092; G-rich RNA sequence binding factor 1 U41315_rna1_s_at Makorin ring finger protein 1; MKRN1 U47414_at Hs.13291 NM_004354; cyclin G2 U49352_at Hs.414754 NM_001359; 2,4-dienoyl CoA reductase 1 precursor U50708_at Hs.1265 NM_000056; branched chain keto acid dehydrogenase E1, beta polypeptide precursor NM_183050; branched chain keto acid dehydrogenase E1, beta polypeptide precursor U77970_at Hs.321164 NM_002518; neuronal PAS domain protein 2 NM_032235; X13334_at Hs.75627 NM_000591; CD14 antigen precursor X57579_s_at Inhibin, beta A; INHBA X64072_s_at Hs.375957 NM_000211; integrin beta chain, beta 2 precursor X68194_at Hs.80919 NM_006754; synaptophysin-like protein isoform a NM_182715; synaptophysin-like protein isoform b X73882_at Hs.254605 NM_003980; microtubule-associated protein 7 X78520_at Hs.372528 NM_001829; chloride channel 3 Z48605_at Hs.421825 NM_006903; inorganic pyrophosphatase 2 isoform 2 NM_176865; NM_176866; inorganic pyrophosphatase 2 isoform 3 NM_176867; inorganic pyrophosphatase 2 isoform 4 NM_176869; inorganic pyrophosphatase 2 isoform 1 Z74615_at Hs.172928 NM_000088; alpha 1 type I collagen preproprotein

TABLE 14 10 genes for classifier UniGene Chip acc. # Build 162 description D89377_at Hs.89404 NM_002449; msh homeo box homolog 2 S77393_at Hs.145754 NM_016531; Kruppel-like factor 3 (basic) U41315_rna1_s_at Makorin ring finger protein 1; MKRN1 U47414_at Hs.13291 NM_004354; cyclin G2 U77970_at Hs.321164 NM_002518; neuronal PAS domain protein 2 NM_032235; X68194_at Hs.80919 NM_006754; synaptophysin-like protein isoform a NM_182715; synaptophysin-like protein isoform b X73882_at Hs.254605 NM_003980; microtubule-associated protein 7 X78520_at Hs.372528 NM_001829; chloride channel 3 Z48605_at Hs.421825 NM_006903; inorganic pyrophosphatase 2 isoform 2 NM_176865; NM_176866; inorganic pyrophosphatase 2 isoform 3 NM_176867; inorganic pyrophosphatase 2 isoform 4 NM_176869; inorganic pyrophosphatase 2 isoform 1 Z74615_at Hs.172928 NM_000088; alpha 1 type I collagen preproprotein

TABLE 15 32 genes for classifier UniGene Chip acc. # Build 162 description D83920_at Hs.440898 NM_002003; ficolin 1 precursor HG67-HT67_f_at HG907-HT907_at J05032_at Hs.32393 NM_001349; aspartyl-tRNA synthetase K01396_at Hs.297681 NM_000295; serine (or cysteine) proteinase inhibitor, clade A (alpha-1 antiproteinase, antitrypsin), member 1 M16591_s_at Hs.89555 NM_002110; hemopoietic cell kinase isoform p61HCK M32011_at Hs.949 NM_000433; neutrophil cytosolic factor 2 M33195_at Hs.433300 NM_004106; Fc fragment of IgE, high affinity I, receptor for, gamma polypeptide precursor M37033_at Hs.443057 NM_000560; CD53 antigen M57731_s_at Hs.75765 NM_002089; chemokine (C-X-C motif) ligand 2 M63262_at Arachidonate 5-lipoxygenase-activating protein; ALOX5AP S77393_at Hs.145754 NM_016531; Kruppel-like factor 3 (basic) U01833_at Hs.81469 NM_002484; nucleotide binding protein 1 (MinD homolog, E. coli) U07231_at Hs.309763 NM_002092; G-rich RNA sequence binding factor 1 U41315_rna1_s_at Makorin ring finger protein 1; MKRN1 U47414_at Hs.13291 NM_004354; cyclin G2 U50708_at Hs.1265 NM_000056; branched chain keto acid dehydrogenase E1, beta polypeptide precursor NM_183050; branched chain keto acid dehydrogenase E1, beta polypeptide precursor U52101_at Hs.9999 NM_001425; epithelial membrane protein 3 U74324_at Hs.90875 NM_002871; RAB-interacting factor U77970_at Hs.321164 NM_002518; neuronal PAS domain protein 2 NM_032235; U90549_at Hs.236774 NM_006353; high mobility group nucleosomal binding domain 4 X13334_at Hs.75627 NM_000591; CD14 antigen precursor X54489_rna1_at chemokine (C-X-C motif) ligand 1 (melanoma growth stimulating activity, alpha) FSP; CXCL1 X57579_s_at Inhibin, beta A; INHBA X64072_s_at Hs.375957 NM_000211; integrin beta chain, beta 2 precursor X68194_at Hs.80919 NM_006754; synaptophysin-like protein isoform a NM_182715; synaptophysin-like protein isoform b X73882_at Hs.254605 NM_003980; microtubule-associated protein 7 X78520_at Hs.372528 NM_001829; chloride channel 3 X95632_s_at Hs.387906 NM_005759; abl-interactor 2 Z29331_at Hs.372758 NM_003344; ubiquitin-conjugating enzyme E2H isoform 1 NM_182697; ubiquitin-conjugating enzyme E2H isoform 2 Z48605_at Hs.421825 NM_006903; inorganic pyrophosphatase 2 isoform 2 NM_176865; NM_176866; inorganic pyrophosphatase 2 isoform 3 NM_176867; inorganic pyrophosphatase 2 isoform 4 NM_176869; inorganic pyrophosphatase 2 isoform 1 Z74615_at Hs.172928 NM_000088; alpha 1 type I collagen preproprotein

Recurrence Predictor

An outcome predictor able to identify the likely presence or absence of recurrence in patients with superficial Ta tumors was also tested (see Table 16).

Table 16. Patient Disease Course Information—Recurrence Vs. No Recurrence

From the hierarchical cluster analysis of the tumor samples it was found that the tumors with a high recurrence frequency were separated from the tumors with low recurrence frequency. To study this further two groups of Ta tumors were profiled—15 tumors with low recurrence frequency and 16 tumors with high recurrence frequency. To avoid influence from other tumor characteristics only tumors that showed the same growth pattern and tumors that showed no sign of concomitant carcinoma in situ were used. Furthermore, the tumors were all primary tumors. The tumors used for identifying genes differentially expressed in recurrent and non-recurrent tumors are listed in Table 16 below.

TABLE 16 Disease course information of all patients involved. Pa- Tumor Carcinoma Time to Group tient (date) Pattern in situ recurrence A 968-1 Ta gr2 Papillary no 27 month  A 928-1 Ta gr2 Papillary no 38 month.  A 934-1 Ta gr2 Papillary no — (22 Jul. 1998) A 709-1 Ta gr2 Papillary no — (21 Jul. 1998) A 930-1 Ta gr2 Papillary no — (30 Jun. 1998) A 524-1 Ta gr2 Papillary no — (20 Oct. 1995) A 455-1 Ta gr2 Papillary no — (06 Jun. 1995) A 370-1 Ta gr2 Papillary no — (10 Jan. 1995) A 810-1 Ta gr2 Papillary no — (03 Oct. 1997) A 1146-1  Ta gr2 Papillary no — (23 Nov. 1999) A 1161-1  Ta gr2 Mixed no — (10 Dec. 1999) A 1006-1  Ta gr2 Papillary no — (23 Nov. 1998) A 942-1 Ta gr2 Papillary no 24 month.  A 1060-1  Ta gr2 Papillary no 36 month.  A 1255-1  Ta gr2 Papillary no 24 month.  B 441-1 Ta gr2 Papillary no 6 month. B 780-1 Ta gr2 Papillary no 2 month. B 815-2 Ta gr2 Papillary no 6 month. B 829-1 Ta gr2 Papillary no 4 month. B 861-1 Ta gr2 Papillary no 4 month. B 925-1 Ta gr2 Papillary no 5 month. B 1008-1  Ta gr2 Papillary no 5 month. B 1086-1  Ta gr2 Papillary no 6 month. B 1105-1  Ta gr2 Papillary no 8 month. B 1145-1  Ta gr2 Papillary no 4 month. B 1327-1  Ta gr2 Papillary no 5 month. B 1352-1  Ta gr2 Papillary no 6 month. B 1379-1  Ta gr2 Papillary no 5 month. B 533-1 Ta gr2 Papillary no 4 month. B 679-1 Ta gr2 Papillary no 4 month. B 692-1 Ta gr2 Papillary no 5 month. Group A: Primary tumors from patients with no recurrence of the disease for 2 years. Group B: Primary tumors from patients with recurrence of the disease within 8 months.

Supervised Learning Prediction of Recurrence

Herein, genes differentially expressed between non-recurring and recurring tumors were identified. Cross-validation and prediction was performed as previously described, except that genes are selected based on the value of the Wilcoxon statistic for difference between the two groups.

Prediction Performance

The prediction performance was tested using from 1-200 genes in the cross-validation loops. FIG. 7 shows that the lowest error rate (8 errors) is obtained in e.g. the cross-validation model using from 39 genes. This cross-validation model was selected as the final predictor, based on these results. The prediction results from the 39 gene cross-validation loops are listed in Table 17. The predictor misclassified four of the samples in each group, and in one of the predictions the difference in the distances between the two group means is below the 5% difference limit, as described above. The probability of misclassifying 8 or less arrays by a random classification is 0.0053.

TABLE 17 Recurrence prediction results of 39 gene cross-validation loops. Tumor Prediction Group Patient (date) Prediction Error strength A 968-1 Ta gr2 0 0.19 A 928-1 Ta gr2 0 0.49 A 934-1 Ta gr2 0 1.73 (22 Jul. 1998) A 709-1 Ta gr2 0 0.45 (21 Jul. 1998) A 930-1 Ta gr2 0 0.82 (30 Jun. 1998) A 524-1 Ta gr2 0 0.14 (20 Oct. 1995) A 455-1 Ta gr2 1 * 0.68 (06 Jun. 1995) A 370-1 Ta gr2 0 0.32 (10 Jan. 1995) A 810-1 Ta gr2 0 0.45 (03 Oct. 1997) A 1146-1  Ta gr2 0 0.98 (23 Nov. 1999) A 1161-1  Ta gr2 0 0.03 (10 Dec. 1999) A 1006-1  Ta gr2 1 * 1.57 (23 Nov. 1998) A 942-1 Ta gr2 0 0.31 A 1060-1  Ta gr2 1 * 0.81 A 1255-1  Ta gr2 1 * 0.71 B 441-1 Ta gr2 1 1.03 B 780-1 Ta gr2 1 0.37 B 815-2 Ta gr2 1 0.35 B 829-1 Ta gr2 1 0.75 B 861-1 Ta gr2 0 * 2.55 B 925-1 Ta gr2 1 0.78 B 1008-1  Ta gr2 0 * 0.12 B 1086-1  Ta gr2 0 * 0.51 B 1105-1  Ta gr2 1 0.37 B 1145-1  Ta gr2 1 0.44 B 1327-1  Ta gr2 1 1.96 B 1352-1  Ta gr2 0 * 0.97 B 1379-1  Ta gr2 1 0.67 B 533-1 Ta gr2 1 0.31 B 679-1 Ta gr2 1 0.82 B 692-1 Ta gr2 1 0.45 Group A: Primary tumors from patients with no recurrence of the disease for 2 years. Group B: Primary tumors from patients with recurrence of the disease within 8 months. Prediction, 0 = no recurrence, 1 = recurrence.

The optimal number of genes in cross-validation loops was found to be 39 (75% of the samples were correctly classified, p<0.006) and from this, the 26 genes that were used in at least 75% of the cross-validation loops were selected to constitute the final recurrence predictor. Consequently, this set of genes is to be used for predicting recurrence in independent samples. The strength of the predictive genes was tested by permutation analysis, see Table 18.

The genes used in at least 29 of the 31 cross-validation loops were selected to constitute the final recurrence prediction model. The expression pattern of those 26 genes is shown in FIG. 12 of application Ser. No. 12/180,321.

TABLE 18 The 26 genes that were found optimal for recurrence prediction. Unigene Feature build 168 Description Number* Test (W-N)** AF006041_at Hs.336916 NM_001350; death-associated protein 6 31 0.054 (161-7) D21337_at Hs.408 NM_001847; type IV alpha 6 collagen isoform A 31 0.058 (160-6) precursor NM_033641; type IV alpha 6 collagen isoform B precursor D49387_at Hs.294584 NM_012212; NADP-dependent leukotriene B4 31 0.118 (313-8) 12-hydroxydehydrogenase D64154_at Hs.90107 NM_007002; adhesion regulating molecule 1 31 0.078 (165-9) precursor NM_175573; adhesion regulating molecule 1 precursor D83780_at Hs.437991 NM_014846; KIAA0196 gene product 31 0.094 (159-4) D87258_at Hs.75111 NM_002775; protease, serine, 11 30  0.112 (168-11) D87437_at Hs.43660 NM_014837; chromosome 1 open reading 31 0.058 (160-6) frame 16 HG1879-HT1919_at 31 0.122 (314-7) HG3076-HT3238_s_at 31  0.080 (309-17) HG511-HT511_at 31 0.348 (319-2) L34155_at Hs.83450 NM_000227; laminin alpha 3 subunit precursor 31 0.122 (314-7) L38928_at Hs.118131 NM_006441; 5,10-methenyltetrahydrofolate 29 0.348 (319-2) synthetase (5-formyltetrahydrofolate cyclo- ligase) L49169_at Hs.75678 NM_006732; FBJ murine osteosarcoma viral 31 0.108 (155-2) oncogene homolog B M16938_s_at Hs.820 NM_004503; homeo box C6 isoform 1 29  0.09 (170-16) NM_153693; homeo box C6 isoform 2 M63175_at Hs.295137 NM_001144; autocrine motility factor receptor 29  0.098 (308-18) isoform a NM_138958; autocrine motility factor receptor isoform b M64572_at Hs.405666 NM_002829; protein tyrosine phosphatase, 31  0.064 (305-31) non-receptor type 3 M98528_at Hs.79404 NM_014392; DNA segment on chromosome 4 31 0.122 (314-7) (unique) 234 expressed sequence U21858_at Hs.60679 NM_003187; TBP-associated factor 9 31 0.122 (314-7) NM_016283; adrenal gland protein AD-004 U45973_at Hs.178347 NM_016532; skeletal muscle and kidney 31  0.094 (310-14) enriched inositol phosphatase isoform 1 NM_130766; skeletal muscle and kidney enriched inositol phosphatase isoform 2 U58516_at Hs.3745 NM_005928; milk fat globule-EGF factor 8 29  0.100 (175-28) protein U62015_at Hs.8867 NM_001554; cysteine-rich, angiogenic inducer, 31  0.106 (169-13) 61 U66702_at Hs.74624 NM_002847; protein tyrosine phosphatase, 31 0.146 (149-1) receptor type, N polypeptide 2 isoform 1 precursor NM_130842; protein tyrosine phosphatase, receptor type, N polypeptide 2 isoform 2 precursor NM_130843; protein tyrosine phosphatase, receptor type, N polypeptide 2 isoform 3 precursor U70439_s_at Hs.84264 NM_006401; acidic (leucine-rich) nuclear 30  0.08 (309-17) phosphoprotein 32 family, member B U94855_at Hs.381255 NM_003754; eukaryotic translation initiation 30  0.092 (311-12) factor 3, subunit 5 epsilon, 47 kDa X63469_at Hs.77100 NM_002095; general transcription factor IIE, 31  0.092 (311-12) polypeptide 2, beta 34 kDa Z23064_at Hs.380118 NM_002139; RNA binding motif protein, X 30  0.066 (307-24) chromosome *Number: Number of times the gene has been used in a cross-validation loop. **Test: The numbers in parenthesis are the value W of the Wilcoxon test statistic for no difference between the two groups together with the number N of genes for which the Wilcoxon test statistic is bigger than or equal to the value W. The test value is obtained from 500 permutations of the arrays. In each permutation new pseudogroups were formed where both of the pseudogroups have the same proportion of arrays from the two original groups. For each permutation the number of genes for which the Wilcoxon test statistic based on the pseudogroups is bigger than or equal to W was counted, and the test value is the proportion of the permutations for which this number is bigger than or equal to N. Thus the test value measures the significance of the observed value W. Consequently, for most of the selected genes, one only finds as least as strongly predictive genes in about 10% of the formed pseudogroups.

Data are presented here on expression patterns that classify the benign and muscle-invasive bladder carcinomas. Furthermore, one can identify subgroups of bladder cancer such as Ta tumors with surrounding CIS, Ta tumors with a high probability of progression as well as recurrence, and T2 tumors with squamous metaplasia. As a novel finding, the matrix remodelling gene cluster was specifically expressed in the tumours having the worst prognosis, namely the T2 tumours and tumours surrounded by CIS. For some of these genes new small molecule inhibitors already exist (Kerr et al. 2002), and thus they form drug targets. At present it is not possible to clinically identify patients, who will experience recurrence and non-recurrence, but it would be a great benefit to both the patients and the health system, as it would reduce the number of unnecessary control examinations in bladder tumor patients. To determine the optimal gene-set for separating non-recurrent and recurrent tumors, a cross-validation scheme using from 1-200 genes was again applied. It was determined that the optimal number of genes in cross-validation loops was 39 (75% of the samples were correctly classified, p<0.01, FIG. 7) and from this the 26 genes (FIG. 12 in Ser. No. 12/180,321) were selected that were used in at least 75% of the cross-validation loops to constitute the final recurrence predictor. Consequently, this set of genes is to be used for predicting recurrence in independent samples. The strength of the predictive genes was tested by performing 500 permutations of the arrays. This revealed that for most of the predictive genes only in a small number of the new pseudo-groups would one obtain equally as good predictors as in the real groups.

Biological Material

66 bladder tumor biopsies were sampled from patients following removal of the necessary amount of tissue for routine pathology examination. The tumors were frozen immediately after surgery and stored at −80° C. in a guanidinium thiocyanate solution. All tumors were graded according to Bergkvist et al. 1965 and re-evaluated by a single pathologist. As normal urothelial reference samples, a pool of biopsies (from 37 patients) as well as three single bladder biopsies from patients with prostatic hyperplasia or urinary incontinence were used. Informed consent was obtained in all cases and protocols were approved by the local scientific ethical committee.

RNA Purification and cRNA Preparation

Total RNA was isolated from crude tumor biopsies using a Polytron homogenisator and the RNAzol B RNA isolation method (WAK-Chemie Medical GmbH). 10 μg total RNA was used as starting material for the cDNA preparation. The first and second strand cDNA synthesis was performed using the SuperScript Choice System (Life Technologies) according to the manufacturers' instructions except using an oligo-dT primer containing a T7 RNA polymerase promoter site. Labelled cRNA was prepared using the BioArray High Yield RNA Transcript Labelling Kit (Enzo). Biotin labelled CTP and UTP (Enzo) were used in the reaction together with unlabeled NTP's. Following the IVT reaction, the unincorporated nucleotides were removed using RNeasy columns (Qiagen).

Array Hybridisation and Scanning

15 μg of cRNA was fragmented at 94° C. for 35 min in a fragmentation buffer containing 40 mM Tris-acetate pH 8.1, 100 mM KOAc, 30 mM MgOAc. Prior to hybridisation, the fragmented cRNA in a 6×SSPE-T hybridisation buffer (1 M NaCl, 10 mM Tris pH 7.6, 0.005% Triton), was heated to 95° C. for 5 min and subsequently to 45° C. for 5 min before loading onto the Affymetrix probe array cartridge (HuGeneFL). The probe array was then incubated for 16 h at 45° C. at constant rotation (60 rpm). The washing and staining procedure was performed in the Affymetrix Fluidics Station. The probe array was exposed to 10 washes in 6×SSPE-T at 25° C. followed by 4 washes in 0.5×SSPE-T at 50° C. The biotinylated cRNA was stained with a streptavidin-phycoerythrin conjugate, final concentration 2 (Molecular Probes, Eugene, Oreg.) in 6×SSPE-T for 30 min at 25° C., followed by 10 washes in 6×SSPE-T at 25° C. The probe arrays were scanned at 560 nm using a confocal laser-scanning microscope (Hewlett Packard GeneArray Scanner G2500A). The readings from the quantitative scanning were analysed by the Affymetrix Gene Expression Analysis Software. An antibody amplification step followed using normal goat IgG as blocking reagent, final concentration 0.1 mg/ml (Sigma) and biotinylated anti-streptavidin antibody (goat), final concentration 3 μg/ml (Vector Laboratories). This was followed by a staining step with a streptavidin-phycoerythrin conjugate, final concentration 2 μg/μl (Molecular Probes, Eugene, Oreg.) in 6×SSPE-T for 30 min at 25° C. and 10 washes in 6×SSPE-T at 25° C. The arrays were then subjected to a second scan under similar conditions as described above.

Class Discovery Using Hierarchical Clustering

All microarray results were scaled to a global intensity of 150 units using the Affymetrix GeneChip software. Other ways of array normalisation exist (Li and Hung 2001), however, using the dCHIP approach did not change the expression profiles of the obtained classifier genes in this study (results not shown). For hierarchical cluster analysis and molecular classification procedures, expression level ratios between tumors and the normal urothelium reference pool were calculated using the comparison analysis implemented in the Affymetrix GeneChip software. In order to avoid expression ratios based on saturated gene-probes, the antibody amplified expression-data for genes with a mean Average Difference value across all samples below 1000 and the non-amplified expression-data for genes with values equal to or above 1000 in mean Average Difference value across all samples was used. Consequently, gene expression levels across all samples were either from the amplified or the non-amplified expression-data. Different filtering criteria were applied to the expression data in order to avoid including non-varying and very low expressed genes in the data analysis. Firstly, only genes that showed significant changes in expression levels compared to the normal reference pool in at least three samples were selected. Secondly, only genes with at least three “Present” calls across all samples were selected. Thirdly, genes varying less than 2 standard deviations across all samples were eliminated. The final gene-set contained 1767 genes following filtering. Two-way hierarchical agglomerative cluster analysis was performed using the Cluster software. Average linkage clustering with a modified Pearson correlation as a similarity metric was used. Genes and arrays were median centred and normalized to the magnitude of 1 prior to cluster analysis. The TreeView software was used for visualization of the cluster analysis results (Eisen et al. 1998). Multidimensional scaling was performed on median centered and normalized data using an implementation in the SPSS statistical software package.

Tumor Stage Classifier

The classifier was based on the log-transformed expression level ratios. For these transformed values, a normal distribution with the mean dependent on the gene and the group (Ta, T1, and T2, respectively) was used, and the variance depended only on the gene. For each gene, the variation within the groups (W) and the three variations between two groups (B(Ta/T1), B(Ta/T2), B(T1/T2)) was calculated, and the three B/W ratios were used to select genes. Those selected genes had a high value of B(Ta/T1)/W, a high value of B(Ta/T2)/W, or a high value of B(T1/T2)/W. To classify a sample, the sum over the genes of the squared distance from the sample value to the group mean, standardized by the variance, was calculated. Thus, a distance to each of the three groups and the sample was classified as belonging to the group in which the distance was smallest. When calculating these distances, the group means and the variances were estimated from all the samples in the training set excluding the sample being classified.

Recurrence Prediction Using a Supervised Learning Method

Average Difference values were generated using the Affymetrix GeneChip software and all values below 20 were set to 20 to avoid very low and negative numbers. Only genes were included that had a “Present” call in at least 7 samples and genes that showed intensity variation (Max−Min>100, Max/Min>2). The values were log were transformed and rescaled a supervised learning method was used essentially as described (Shipp et al. 2002). Genes were selected using t-test statistics and cross-validation and sample classification, performed as described above.

Immunohistochemistry

Tumor tissue microarrays were prepared essentially as described (Kononen et al. 1998), with four representative 0.6 mm paraffin cores from each study case. Immunohistochemical staining was performed using standard highly sensitive techniques after appropriate heat-induced antigen retrieval. Primary polyclonal goat antibodies against Smad 6 (S-20) and cyclin G2 (N-19) were obtained from Santa Cruz Biotechnology. Antibodies to p53 (monoclonal DO-7) and Her-2 (polyclonal anti-c-erbB-2) were from Dako A/S. Ki-67 monoclonal antibody (MIBI) was from Novocastra Laboratories Ltd. Staining intensity was scored at four levels, Negative, Weak, Moderate and Strong by an experienced pathologist who considered both color intensity and number of stained cells, and who was unaware of array results.

Example 3 A Molecular Classifier Detects Carcinoma In Situ Expression Signatures in Tumors and Normal Urothelium of the Bladder Clinical Samples

Bladder tumor samples were obtained directly from surgery following removal of tissue for routine pathological examination. The samples were immediately submerged in a guadinium thiocyanate solution for RNA preservation and stored at −80° C. Informed consent was obtained in all cases, and the protocols were approved by the scientific ethical committee of Aarhus County. Samples in the No-CIS group were selected based on the following criteria: a) Ta tumors with no CIS in selected site biopsies in all visits; b) no previous muscle invasive tumour. Samples in the CIS group were selected based on the criteria: a) Ta or T1 tumours with CIS in selected site biopsies in any visit (preferably Ta tumors with CIS in the sampling visit); b) no previous muscle invasive tumors. Normal biopsies were obtained from individuals with prostatic hyperplasia or urinary incontinence. CIS and “normal” biopsies were obtained from cystectomy specimens directly following removal of the bladder. A grid was placed in the bladder for orientation and biopsies were taken from 8 positions covering the bladder surface. At each position, three biopsies were taken: two for pathologic examination and one in between these for RNA extraction for microarray expression profiling. The samples for RNA extraction were immediately transferred to the guanidinium thiocyanate solution and stored at −80° C. until used. Samples used for RNA extraction were assumed to have CIS if CIS was detected in both adjacent biopsies. The “normal” samples were assumed to be normal if both adjacent biopsies were normal.

cRNA Preparation, Array Hybridisation and Scanning

Purification of total RNA, preparation of cRNA from cDNA and hybridization and scanning were performed as previously described (Dyrskjot et al. 2003). The labelled samples were hybridized to Affymetrix U133A GeneChips.

Expression Data Analysis

Following scanning, all data were normalized using the RMA normalization approach in the Bioconductor Affy package to R. Variation filters were applied to the data to eliminate non-varying and presumably non-expressed genes. For gene-set 1, this was done by only including genes with a minimum expression above 200 in at least 5 samples and genes with max/min expression intensities above or equal to 3. The filtering for gene-set 2 including only genes with a minimum expression of 200 in at least 3 samples and genes with maximum expression intensities above or equal to 3. Average linkage hierarchical cluster analysis was carried out using the Cluster software with a modified Pearson correlation as a similarity metric (Eisen et al. 1998). TreeView software was used for visualization of the cluster analysis results (Eisen et al. 1998). Genes were log-transformed, median centered and normalized to the magnitude of 1 before clustering.

GeneCluster 2.0 (http://www-genome.wi.mitedu/cancer/software/genecluster2/gc2.html) was used for the supervised selection of markers and for permutation testing. The algorithms used in the software are based on (Golub et al. 1999, Tamayo et al. 1999). Classifiers for CIS detection were built using the same methods as described previously (Dyrskjot et al. 2003).

Gene Expression Profiling

High-density oligonucleotide microarrays were used for gene expression profiling of approximately 22,000 genes in 28 superficial bladder tumor biopsies (13 tumors with surrounding CIS and 15 without surrounding CIS) and in 13 invasive carcinomas. See table 19 for patient disease course descriptions. Furthermore, expression profiles were obtained from 9 normal biopsies and from 10 biopsies from cystectomy specimens (5 histologically normal biopsies and 5 biopsies with CIS).

TABLE 19 Clinical data on patient disease courses and results of molecular CIS classification Sample Previous Tumor Subsequent CIS group^(a) Patient^(b) tumors analysed tumors CIS^(c) classifier^(d) 1 1060-1 Ta gr2 2 Ta No No CIS 1 1146-1 Ta gr2 No No CIS 1 1216-1 Ta gr2 No No CIS 1 1303-1 Ta gr2 No No CIS 1 524-1 Ta gr2 No No CIS 1 692-1 Ta gr2 2 Ta No No CIS 1 1264-1 Ta gr3 20 Ta No No CIS 1 1350-1 Ta gr3 1 Ta No No CIS 1 1354-1 Ta gr3 11 T1 No No CIS 1 775-1 Ta gr3 1 Ta No No CIS 1 1066-1 Ta gr3 1 Ta No No CIS 1 1276-1 Ta gr3 2 T1 No No CIS 1 1070-1 Ta gr3 1 Ta No No CIS 1 989-1 Ta gr3 No No CIS 1 1482-1 Ta gr3 20 Ta No CIS 2 1345-2 1 T1 Ta gr3 Sampling visit CIS 2 1062-2 Ta gr3 1 T1 Sampling visit CIS 2 956-2 Ta gr3 1 Ta Sampling visit CIS 2 320-7 1 Ta, 2 T1 Ta gr3 2 Ta Sampling visit CIS 2 1330-1 Ta gr3 Sampling visit CIS 2 602-8 5 Ta Ta gr3 3 Ta Sampling visit CIS 2 763-1 Ta gr2 14 Ta Sampling visit CIS 2 1024-1 T1 gr3 2 Ta, 1 T1 Sampling visit CIS 2 1182-1 Ta gr3 7 Ta Subsequent visit CIS 2 1093-1 Ta gr3 4 Ta, 1 T1 Subsequent visit CIS 2 979-1 Ta gr3 Sampling visit CIS 2 1337-1 T1 gr3 Sampling visit CIS 2 1625-1 Ta gr2 Sampling visit CIS 3 1015-1 T3b gr4 No — 3 1337-1 T4a gr3 Sampling visit — 3 1041-1 T4b gr3 No — 3 1044-1 T4b gr3 ND — 3 1055-1 1 Ta gr2 T3a gr3 No — 3 1109-1 T2 gr3 1 T2-4 No — 3 1124-1 T4a gr3 2 T2-4 No — 3 1154-1 T3a gr3 1 Ta, 1 T2-4 No — 3 1167-1 1 T2-4 T3b gr4 2 T2-4 ND — 3 1178-1 T4b gr3 ND — 3 1215-1 T4b gr3 ND — 3 1271-1 T3b gr4 No — 3 1321-1 1 T1 T3b gr? ND — ^(a)The tumor groups involved were TCC without CIS (1), TCC with CIS (2) and invasive TCC (3). ^(b)The numbers indicate the patient number followed by the clinic visit number. ^(c)CIS in selected site biopsies in previous, present or subsequent visits to the clinic. ND: not determined. ^(d)Molecular classification of the samples using 25 genes in cross-validation loops.

Hierarchical Cluster Analysis

Following appropriate normalization and expression intensity calculations, genes that showed high variation across the 41 TCC samples were selected for further analysis. The filtering produced a gene-set consisting of 5,491 genes (gene-set 1) and two-way hierarchical cluster analysis was performed based on this gene-set. The sample clustering showed a separation of the three groups of samples with only few exceptions (FIG. 14a in Ser. No. 12/180,321). Superficial TCC with surrounding CIS clustered in the one main branch of the dendrogram, while the superficial TCC without CIS and the invasive TCC clustered in two separate sub-branches in the other main branch of the dendrogram. The only exceptions were that the invasive TCC samples 1044-1 and 1124-1 clustered in the CIS group, and two TCC with CIS clustered in the invasive group (samples 1330-1 and 956-2). The only TCC without CIS that clustered in the CIS group was sample 1482-1. The distinct clustering of the tumour groups indicated a large difference in gene expression patterns.

Hierarchical clustering of the genes (FIG. 14c in Ser. No. 12/180,321) identified large clusters of genes characteristic for each tumor phenotype. Cluster 1 showed a cluster of genes down-regulated in cystectomy biopsies, TCC with adjacent CIS and in some invasive carcinomas (FIG. 14c in Ser. No. 12/180,321). There is no obvious functional relationship between the genes in this cluster. Cluster 2 showed a tight cluster of genes related to immunology and cluster 3 contained mostly genes expressed in muscle and connective tissue. Expression of genes in this cluster was observed in the normal and cystectomy samples, and in a fraction of the TCC with CIS and in the invasive tumours. Cluster 4 contained genes up-regulated in the cystectomy biopsies, TCC with adjacent CIS and in invasive carcinomas (FIG. 14c in Ser. No. 12/180,321). This cluster includes genes involved in cell cycle regulation, and in cell proliferation and apoptosis. However, for most of the genes in this cluster there is no apparent functional relationship. Comparisons of chromosomal location of the genes in the clusters revealed no correlation between the observed gene clusters and chromosomal position of the identified genes.

A positive correlation could have indicated chromosomal loss or gain or chromosomal inactivation by e.g. methylation of common promoter regions.

To analyze the impact of surrounding CIS lesions further, the 28 superficial tumours only were used. A new gene set was created consisting of 5,252 varying genes (gene-set 2). Hierarchical cluster analysis of the tumor samples (FIG. 13b in Ser. No. 12/180,321) based on the new gene-set separated the samples according to the presence of CIS in the surrounding urothelium, with only 1 exception (P<0.000001, χ²-test). Sample 1482-1 clustered in the TCC with CIS group; however, no CIS has been detected in selected site biopsies during routine examinations of this patient. Tumour samples 1182-1 and 1093-1 did not have CIS in selected site biopsies in the same visit as the profiled tumor, but showed this in later visits. However, the profile of these two superficial tumor samples already showed the adjacent CIS profile.

Marker Selection

To delineate the tumors with surrounding CIS from the tumors without CIS, t-test statistics were used to select the 50 most up-regulated genes in each group (FIG. 9). Permutation of the sample labels 500 times revealed that the 50 genes up-regulated in the CIS-group are highly significantly differentially expressed and unlikely to be found by chance, as all markers were significant at a 5% confidence level. Consequently, in 500 random datasets, it was only possible to select equally genes in less than 5% of the datasets. The 50 genes up-regulated in the no-CIS group showed a poorer performance in the permutation tests, as these were not significant at a 5% confidence level. See Table 20 for details. The relative expression of these 100 genes in 9 normal biopsies and 10 biopsies from cystectomies with CIS is shown in FIG. 15 b. The no-CIS profile was found in all of the normal samples. However, all histologically normal samples adjacent to the CIS lesions, as well as the CIS biopsies, showed the CIS profile.

TABLE 20 The best 100 markers Feature (U133 Perm Perm Perm array) Class T-test 1% 5% 10% UniGene Build 162 RefSeq; description 221204_s_at no_CIS 3.74 5.12 4.61 4.33 Hs.326444 NM_018058; cartilage acidic protein 1 205927_s_at no_CIS 3.67 4.53 3.98 3.73 Hs.1355 NM_001910; cathepsin E isoform a preproprotein NM_148964; cathepsin E isoform b preproprotein 210143_at no_CIS 3.35 4.03 3.73 3.45 Hs.188401 NM_007193; annexin A10 204540_at no_CIS 3.15 3.87 3.51 3.32 Hs.433839 NM_001958; eukaryotic translation elongation factor 1 alpha 2 214599_at no_CIS 3.02 3.75 3.37 3.14 Hs.157091 NM_005547; involucrin 203649_s_at no_CIS 2.84 3.63 3.20 3.00 Hs.76422 NM_000300; phospholipase A2, group IIA (platelets, synovial fluid) 203980_at no_CIS 2.74 3.47 3.12 2.89 Hs.391561 NM_001442; fatty acid binding protein 4, adipocyte 209270_at no_CIS 2.39 3.38 3.10 2.85 Hs.436983 NM_000228; laminin subunit beta 3 precursor 206658_at no_CIS 2.35 3.37 3.05 2.78 Hs.284211 NM_030570; uroplakin 3B isoform a NM_182683; uroplakin 3B isoform c NM_182684; uroplakin 3B isoform b 220779_at no_CIS 2.35 3.33 2.97 2.73 Hs.149195 NM_016233; peptidylarginine deiminase type III 216971_s_at no_CIS 2.28 3.29 2.91 2.71 Hs.79706 NM_000445; plectin 1, intermediate filament binding protein 500 kDa 206191_at no_CIS 2.25 3.24 2.86 2.68 Hs.47042 NM_001248; ectonucleoside triphosphate diphosphohydrolase 3 218484_at no_CIS 2.18 3.20 2.81 2.62 Hs.221447 NM_020142; NADH:ubiquinone oxidoreductase MLRQ subunit homolog 221854_at no_CIS 2.1 3.19 2.80 2.60 Hs.313068 NM_000299; plakophilin 1 203792_x_at no_CIS 2.02 3.16 2.74 2.55 Hs.371617 NM_007144; ring finger protein 110 207862_at no_CIS 2.01 3.16 2.72 2.52 Hs.379613 NM_006760; uroplakin 2 218960_at no_CIS 1.93 3.14 2.65 2.47 Hs.414005 NM_019894; transmembrane protease, serine 4 isoform 1 NM_183247; transmembrane protease, serine 4 isoform 2 203009_at no_CIS 1.93 3.12 2.62 2.45 Hs.155048 NM_005581; Lutheran blood group (Auberger b antigen included) 204508_s_at no_CIS 1.88 3.10 2.60 2.42 Hs.279916 NM_017689; hypothetical protein FLJ20151 211692_s_at no_CIS 1.87 3.06 2.58 2.39 Hs.87246 NM_014417; BCL2 binding component 3 206465_at no_CIS 1.86 3.04 2.54 2.38 Hs.277543 NM_015162; lipidosin 206122_at no_CIS 1.85 2.92 2.52 2.36 Hs.95582 NM_006942; SRY-box 15 206393_at no_CIS 1.83 2.89 2.49 2.33 Hs.83760 NM_003282; troponin I, skeletal, fast 214639_s_at no_CIS 1.79 2.87 2.49 2.30 Hs.67397 NM_005522; homeobox A1 protein isoform a NM_153620; homeobox A1 protein isoform b 214630_at no_CIS 1.79 2.84 2.44 2.28 Hs.184927 NM_000497; cytochrome P450, subfamily XIB (steroid 11-beta-hydroxylase), polypeptide 1 precursor 204465_s_at no_CIS 1.77 2.81 2.42 2.27 Hs.76888 NM_004692; NM_032727; internexin neuronal intermediate filament protein, alpha 204990_s_at no_CIS 1.76 2.79 2.41 2.24 Hs.85266 NM_000213; integrin, beta 4 205453_at no_CIS 1.75 2.77 2.39 2.22 Hs.290432 NM_002145; homeo box B2 215812_s_at no_CIS 1.74 2.77 2.37 2.20 Hs.499113 NM_018058; cartilage acidic protein 1 217040_x_at no_CIS 1.74 2.75 2.36 2.18 Hs.95582 NM_001910; cathepsin E isoform a preproprotein NM_148964; cathepsin E isoform b preproprotein 203759_at no_CIS 1.73 2.75 2.34 2.17 Hs.75268 NM_007193; annexin A10 211002_s_at no_CIS 1.73 2.74 2.33 2.17 Hs.82237 NM_001958; eukaryotic translation elongation factor 1 alpha 2 216641_s_at no_CIS 1.73 2.73 2.31 2.15 Hs.18141 NM_005547; involucrin 221660_at no_CIS 1.71 2.67 2.30 2.13 Hs.247831 NM_000300; phospholipase A2, group IIA (platelets, synovial fluid) 220026_at no_CIS 1.71 2.66 2.28 2.13 Hs.227059 NM_001442; fatty acid binding protein 4, adipocyte 209591_s_at no_CIS 1.69 2.63 2.28 2.11 Hs.170195 NM_000228; laminin subunit beta 3 precursor 219922_s_at no_CIS 1.68 2.61 2.26 2.08 Hs.289019 NM_030570; uroplakin 3B isoform a NM_182683; uroplakin 3B isoform c NM_182684; uroplakin 3B isoform b 201641_at no_CIS 1.67 2.61 2.26 2.07 Hs.118110 NM_016233; peptidylarginine deiminase type III 204952_at no_CIS 1.66 2.59 2.24 2.07 Hs.377028 NM_000445; plectin 1, intermediate filament binding protein 500 kDa 204487_s_at no_CIS 1.65 2.59 2.23 2.06 Hs.367809 NM_001248; ectonucleoside triphosphate diphosphohydrolase 3 210761_s_at no_CIS 1.64 2.59 2.23 2.05 Hs.86859 NM_020142; NADH:ubiquinone oxidoreductase MLRQ subunit homolog 217626_at no_CIS 1.63 2.58 2.21 2.04 Hs.201967 NM_000299; plakophilin 1 204380_s_at no_CIS 1.62 2.58 2.19 2.03 Hs.1420 NM_007144; ring finger protein 110 205455_at no_CIS 1.61 2.58 2.17 2.02 Hs.2942 NM_006760; uroplakin 2 205073_at no_CIS 1.61 2.58 2.17 2.01 Hs.152096 NM_019894; transmembrane protease, serine 4 isoform 1 NM_183247; transmembrane protease, serine 4 isoform 2 203287_at no_CIS 1.61 2.58 2.16 2.00 Hs.18141 NM_005581; Lutheran blood group (Auberger b antigen included) 210735_s_at no_CIS 1.58 2.55 2.15 1.99 Hs.5338 NM_017689; hypothetical protein FLJ20151 203842_s_at no_CIS 1.57 2.54 2.15 1.97 Hs.172740 NM_014417; BCL2 binding component 3 206561_s_at no_CIS 1.57 2.53 2.14 1.96 Hs.116724 NM_015162; lipidosin 214752_x_at no_CIS 1.56 2.52 2.13 1.95 Hs.195464 NM_006942; SRY-box 15 217028_at CIS 4.87 5.17 4.67 4.40 Hs.421986 NM_003282; troponin I, skeletal, fast 213975_s_at CIS 4.65 4.43 4.01 3.76 Hs.234734 NM_005522; homeobox A1 protein isoform a NM_153620; homeobox A1 protein isoform b 201859_at CIS 4.59 4.15 3.70 3.45 Hs.1908 NM_000497; cytochrome P450, subfamily XIB (steroid 11-beta-hydroxylase), polypeptide 1 precursor 219410_at CIS 4.49 3.98 3.49 3.29 Hs.104800 NM_004692; NM_032727; internexin neuronal intermediate filament protein, alpha 207173_x_at CIS 4.37 3.88 3.33 3.11 Hs.443435 NM_000213; integrin, beta 4 214651_s_at CIS 4.14 3.83 3.22 2.99 Hs.127428 NM_002145; homeo box B2 201858_s_at CIS 4.06 3.78 3.09 2.91 Hs.1908 NM_018058; cartilage acidic protein 1 211430_s_at CIS 4.03 3.63 3.05 2.83 Hs.413826 NM_001910; cathepsin E isoform a preproprotein NM_148964; cathepsin E isoform b preproprotein 213891_s_at CIS 3.86 3.63 3.02 2.77 Hs.359289 NM_007193; annexin A10 221872_at CIS 3.82 3.52 2.89 2.73 Hs.82547 NM_001958; eukaryotic translation elongation factor 1 alpha 2 212386_at CIS 3.77 3.50 2.87 2.69 Hs.359289 NM_005547; involucrin 211161_s_at CIS 3.76 3.42 2.84 2.65 NM_000300; phospholipase A2, group IIA (platelets, synovial fluid) 214669_x_at CIS 3.55 3.36 2.80 2.62 Hs.377975 NM_001442; fatty acid binding protein 4, adipocyte 217388_s_at CIS 3.44 3.31 2.79 2.58 Hs.444471 NM_000228; laminin subunit beta 3 precursor 203477_at CIS 3.36 3.28 2.75 2.56 Hs.409034 NM_030570; uroplakin 3B isoform a NM_182683; uroplakin 3B isoform c NM_182684; uroplakin 3B isoform b 204688_at CIS 3.35 3.26 2.74 2.52 Hs.409798 NM_016233; peptidylarginine deiminase type III 218718_at CIS 3.35 3.22 2.70 2.48 Hs.43080 NM_000445; plectin 1, intermediate filament binding protein 500 kDa 215176_x_at CIS 3.32 3.14 2.67 2.45 Hs.503443 NM_001248; ectonucleoside triphosphate diphosphohydrolase 3 201842_s_at CIS 3.31 3.11 2.65 2.44 Hs.76224 NM_020142; NADH:ubiquinone oxidoreductase MLRQ subunit homolog 212667_at CIS 3.3 3.11 2.63 2.42 Hs.111779 NM_000299; plakophilin 1 209340_at CIS 3.27 3.10 2.61 2.39 Hs.21293 NM_007144; ring finger protein 110 215379_x_at CIS 3.26 3.10 2.59 2.39 Hs.449601 NM_006760; uroplakin 2 200762_at CIS 3.25 3.05 2.56 2.34 Hs.173381 NM_019894; transmembrane protease, serine 4 isoform 1 NM_183247; transmembrane protease, serine 4 isoform 2 211896_s_at CIS 3.21 3.05 2.53 2.32 Hs.156316 NM_005581; Lutheran blood group (Auberger b antigen included) 204141_at CIS 3.19 3.05 2.53 2.28 Hs.300701 NM_017689; hypothetical protein FLJ20151 201744_s_at CIS 3.18 3.03 2.50 2.27 Hs.406475 NM_014417; BCL2 binding component 3 209138_x_at CIS 3.17 3.03 2.47 2.24 Hs.505407 NM_015162; lipidosin 214677_x_at CIS 3.14 3.02 2.47 2.23 Hs.449601 NM_006942; SRY-box 15 212077_at CIS 3.11 2.99 2.46 2.21 Hs.443811 NM_003282; troponin I, skeletal, fast 206392_s_at CIS 3.11 2.98 2.43 2.20 Hs.82547 NM_005522; homeobox A1 protein isoform a NM_153620; homeobox A1 protein isoform b 212998_x_at CIS 3.09 2.94 2.40 2.19 Hs.375115 NM_000497; cytochrome P450, subfamily XIB (steroid 11-beta-hydroxylase), polypeptide 1 precursor 201616_s_at CIS 3.08 2.93 2.38 2.18 Hs.443811 NM_004692; NM_032727; internexin neuronal intermediate filament protein, alpha 205382_s_at CIS 3.07 2.88 2.37 2.15 Hs.155597 NM_000213; integrin, beta 4 212671_s_at CIS 3.07 2.85 2.35 2.14 Hs.387679 NM_002145; homeo box B2 215121_x_at CIS 3.06 2.84 2.34 2.13 Hs.356861 NM_018058; cartilage acidic protein 1 200600_at CIS 3.05 2.83 2.33 2.11 Hs.170328 NM_001910; cathepsin E isoform a preproprotein NM_148964; cathepsin E isoform b preproprotein 202746_at CIS 3.03 2.80 2.32 2.10 Hs.17109 NM_007193; annexin A10 202917_s_at CIS 3 2.79 2.31 2.08 Hs.416073 NM_001958; eukaryotic translation elongation factor 1 alpha 2 201560_at CIS 3 2.79 2.30 2.08 Hs.25035 NM_005547; involucrin 218918_at CIS 2.99 2.77 2.29 2.06 Hs.8910 NM_000300; phospholipase A2, group IIA (platelets, synovial fluid) 218656_s_at CIS 2.99 2.76 2.27 2.06 Hs.93765 NM_001442; fatty acid binding protein 4, adipocyte 201088_at CIS 2.99 2.76 2.26 2.04 Hs.159557 NM_000228; laminin subunit beta 3 precursor 201291_s_at CIS 2.97 2.75 2.25 2.04 Hs.156346 NM_030570; uroplakin 3B isoform a NM_182683; uroplakin 3B isoform c NM_182684; uroplakin 3B isoform b 215076_s_at CIS 2.95 2.72 2.24 2.03 Hs.443625 NM_016233; peptidylarginine deiminase type III 212195_at CIS 2.94 2.71 2.22 2.02 Hs.71968 NM_000445; plectin 1, intermediate filament binding protein 500 kDa 209732_at CIS 2.94 2.68 2.22 2.00 Hs.85201 NM_001248; ectonucleoside triphosphate diphosphohydrolase 3 212192_at CIS 2.94 2.67 2.22 1.99 Hs.109438 NM_020142; NADH:ubiquinone oxidoreductase MLRQ subunit homolog 221671_x_at CIS 2.92 2.67 2.20 1.98 Hs.377975 NM_000299; plakophilin 1 211671_s_at CIS 2.91 2.66 2.20 1.98 Hs.126608 NM_007144; ring finger protein 110 214352_s_at CIS 2.88 2.66 2.19 1.97 Hs.412107 NM_006760; uroplakin 2 Feature: Probe-set on U133A GeneChip Class: The group in which the marker is up-regulated T-test: The t-test value Perm 1%: The 1% permutation level Perm 5%: The 5% permutation level Perm 10%: The 10% permutation level

Construction of a Molecular CIS Classifier

A classifier able to diagnose CIS from gene expressions in TCC or in bladder biopsies may increase the detection rate of CIS. The first approach was to be able to classify superficial TCC with or without CIS in the surrounding mucosa. This could have the effect that the number of random biopsies to be taken could be reduced.

A CIS-classifier was built as previously described (Dyrskjot et al. 2003) using cross-validation for determining the optimal number of genes for classifying CIS with fewest errors. The best classifier performance (1 error) was obtained in cross-validation loops using 25 genes (see FIG. 16 in Ser. No. 12/180,321); 16 of these were included in 70% of the cross-validation loops and these were selected to represent the final classifier for CIS diagnosis (FIG. 10 and table 21). Permutation analysis showed that 13 of these were significant at a 1% confidence level—the remaining three genes were above a 10% confidence level.

TABLE 21 The 16 gene molecular classifier of CIS Feature (U133a Perm Perm UniGene Build array) Class t-test 1% Perm 5% 10% 162 RefSeq; description 213633_at no_CIS 1.51 2.46 2.04 1.85 Hs.97858 NM_018957; SH3-domain binding protein 1 212784_at no_CIS 1.36 2.27 1.86 1.70 Hs.388236 NM_015125; capicua homolog 209241_x_at no_CIS 1.13 1.78 1.48 1.33 Hs.112028 NM_015716; misshapen/NIK-related kinase isoform 1 NM_153827; misshapen/NIK-related kinase isoform 3 NM_170663; misshapen/NIK-related kinase isoform 2 217941_s_at CIS 2.3 1.96 1.66 1.47 Hs.8117 NM_018695; erbb2 interacting protein 201877_s_at CIS 2.27 1.90 1.62 1.45 Hs.249955 NM_002719; gamma isoform of regulatory subunit B56, protein phosphatase 2A isoform a NM_178586; gamma isoform of regulatory subunit B56, protein phosphatase 2A isoform b NM_178587; gamma isoform of regulatory subunit B56, protein phosphatase 2A isoform c NM_178588; gamma isoform of regulatory subunit B56, protein phosphatase 2A isoform d 209630_s_at CIS 1.97 1.54 1.31 1.15 Hs.444354 NM_012164; F-box and WD-40 domain protein 2 202777_at CIS 1.93 1.51 1.29 1.12 Hs.104315 NM_007373; soc-2 suppressor of clear homolog 200958_s_at CIS 1.92 1.49 1.28 1.11 Hs.164067 NM_005625; syndecan binding protein (syntenin) 209579_s_at CIS 1.79 1.36 1.16 1.01 Hs.35947 NM_003925; methyl-CpG binding domain protein 4 209004_s_at CIS 1.63 1.21 1.00 0.89 Hs.5548 NM_012161; F-box and leucine-rich repeat protein 5 isoform 1 NM_033535; F-box and leucine-rich repeat protein 5 isoform 2 218150_at CIS 1.6 1.18 0.98 0.86 Hs.342849 NM_012097; ADP- ribosylation factor-like 5 isoform 1 NM_177985; ADP-ribosylation factor- like 5 isoform 2 202076_at CIS 1.53 1.12 0.92 0.82 Hs.289107 NM_001166; baculoviral IAP repeat-containing protein 2 204640_s_at CIS 1.45 1.03 0.83 0.75 Hs.129951 NM_003563; speckle-type POZ protein 201887_at CIS 1.32 0.92 0.74 0.66 Hs.285115 NM_001560; interleukin 13 receptor, alpha 1 precursor 212802_s_at CIS 1.31 0.91 0.72 0.65 Hs.287266 GTPase activating protein and VPS9 domains 1; GAPVD1 212899_at CIS 1.29 0.89 0.71 0.64 Hs.129836 NM_015076; cyclin- dependent kinase (CDC2- like) 11 Feature: Probe-set on U133A GeneChip Class: The group in which the marker is up-regulated T-test: The t-test value Perm 1%: The 1% permutation level Perm 5%: The 5% permutation level Perm 10%: The 10% permutation level

Exploration of Strength of CIS Classifier

To further explore the strength of classifying CIS a classifier was built by randomly selecting half of the samples for training and the other half was used for testing. Cross validation was used again in the training of this classifier for optimization of the gene-set for classifying independent samples. Cross-validation with 15 genes showed a good performance (see FIG. 18) and 7 of these genes were included in 70% of the class-validation loops. These 7 genes classified the samples in the test set with one error only—sample 1482-1 (χ²-test, P<0.002). Only two of the genes were also included in the 16-gene classifier, which is understandable considering the number of tests performed and the limitations in sample size. This classification performance is notable considering the small number of samples used for training the classifier.

Grouping of Normal and Cystectomies with CIS

Hierarchical cluster analysis was used to group the 9 normal and 10 biopsies from cystectomies with CIS based on the normalized expression profiles of the 16 classifier genes. This clustering separated the samples from cystectomies with CIS lesions from the normal samples with only few exceptions, as 8 of the 10 biopsies from cystectomies were found in the one main branch of the dendrogram and 8 of the 9 normal biopsies were found on the other main branch (χ²-test, P<0.002).

The specific methods and compositions described herein are representative of preferred embodiments and are exemplary and not intended as limitations on the scope of the invention.

Other objects, aspects, and embodiments will occur to those skilled in the art upon consideration of this specification, and are encompassed within the spirit of the invention as defined by the scope of the claims. It will be readily apparent to one skilled in the art that varying substitutions and modifications may be made to the invention disclosed herein without departing from the scope and spirit of the invention. The invention illustratively described herein suitably may be practiced in the absence of any element or elements, or limitation or limitations, which is not specifically disclosed herein as essential. Thus, for example, in each instance herein, in embodiments or examples of the present invention, any of the terms “comprising”, “including”, containing”, etc. are to be read expansively and without limitation. The methods and processes illustratively described herein suitably may be practiced in differing orders of steps, and that they are not necessarily restricted to the orders of steps indicated herein or in the claims. It is also noted that as used herein and in the appended claims, the singular forms “a,” “an,” and “the” include plural reference, and the plural include singular forms, unless the context clearly dictates otherwise. Under no circumstances may the patent be interpreted to be limited to the specific examples or embodiments or methods specifically disclosed herein. Under no circumstances may the patent be interpreted to be limited by any statement made by any Examiner or any other official or employee of the Patent and Trademark Office unless such statement is specifically and without qualification or reservation expressly adopted in a responsive writing by Applicants.

The invention has been described broadly and generically herein. Each of the narrower species and subgeneric groupings falling within the generic disclosure also form part of the invention.

The terms and expressions that have been employed are used as terms of description and not of limitation, and there is no intent in the use of such terms and expressions to exclude any equivalent of the features shown and described or portions thereof, but it is recognized that various modifications are possible within the scope of the invention as claimed. Thus, it will be understood that although the present invention has been specifically disclosed by preferred embodiments and optional features, modification and variation of the concepts herein disclosed may be resorted to by those skilled in the art, and that such modifications and variations are considered to be within the scope of this invention as defined by the appended claims.

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1. A method for determining the likelihood of progression of an individual's bladder cancer, comprising: determining in a bladder tumor sample from the individual, the level of gene expression from the marker MBNL2 wherein if the expression level determined for MBNL2 is increased as compared to the MBNL2 expression level in a control or different bladder cancer sample, it indicates a decreased risk of progression relative to said control or different bladder cancer sample; and wherein if the expression level for MBNL2 is decreased as compared to the MBNL2 expression level in a control or different bladder cancer sample, it indicates an increased risk of progression relative to said control or different bladder cancer sample.
 2. The method of claim 1 wherein the method further includes determining, in the bladder tumor sample, the level of gene expression from the marker FABP4, wherein if the level determined for either or both MBNL2 and FABP4 is increased as compared to their respective relative expression levels in a control or different bladder cancer sample, it indicates a decreased risk of progression relative to said control or different bladder cancer sample; and wherein if the expression level for either or both MBNL2 and FABP4 is decreased as compared to their respective relative expression levels in a control or different bladder cancer sample, it indicates an increased risk of progression relative to said control or different bladder cancer sample.
 3. The method of claim 1 wherein the method further includes determining, in the bladder tumor sample, the level of gene expression from the marker UBE2C wherein if the expression level determined for MBNL2 is increased and the expression level for UBE2C is decreased, as compared to their respective relative expression levels in a control or different bladder cancer sample, it indicates a decreased risk of progression relative to said control or different bladder cancer sample, and if the expression level for UBE2C is increased and the expression level for MBNL2 is decreased, as compared to their respective relative expression levels in said control or different bladder cancer sample, it indicates an increased risk of progression relative to said control or different bladder cancer sample.
 4. The method of claim 1 wherein the method further includes determining, in the bladder tumor sample, the level of gene expression from the marker BIRC5 wherein if the expression level determined for MBNL2 is increased and the expression level for BIRC5 is decreased, as compared to their respective relative expression levels in a control or different bladder cancer sample, it indicates a decreased risk of progression relative to said control or different bladder cancer sample, and if the expression level for BIRC5 is increased and the expression level for MBNL2 is decreased, as compared to their respective relative expression levels in said control or different bladder cancer sample, it indicates an increased risk of progression relative to said control or different bladder cancer sample.
 5. The method of claim 1 wherein the method further includes determining, in the bladder tumor sample, the level of gene expression from the markers FABP4 and UBE2C, wherein if the expression level determined for either or both MBNL2 and FABP4 is increased and the expression level for UBE2C is decreased, as compared to their respective relative expression levels in a control or different bladder cancer sample, it indicates a decreased risk of progression relative to said control or different bladder cancer sample, and if the expression level for UBE2C is increased and the expression level for either or both MBNL2 and FABP4 is decreased, as compared to their respective relative expression levels in said control or different bladder cancer sample, it indicates an increased risk of progression relative to said control or different bladder cancer sample.
 6. The method of claim 1 wherein the method further includes determining, in the bladder tumor sample, the level of gene expression from the markers FABP4 and UBE2C, wherein if the expression level for either or both MBNL2 and FABP4 is increased and the expression level for UBE2C is decreased, as compared to their respective relative expression levels in a control or different bladder cancer sample, it indicates a decreased risk of progression relative to said control or different bladder cancer sample, and if the expression level for UBE2C is increased and the expression level for either or both MBNL2 and FABP4 is decreased, as compared to their respective relative expression levels in said control or different bladder cancer sample, it indicates an increased risk of progression relative to said control or different bladder cancer sample.
 7. The method of claim 1 wherein the method further includes determining, in the bladder tumor sample, the level of gene expression from the markers UBE2C and BIRC5, wherein if the expression level for MBNL2 is increased and the expression level for either or both UBE2C and BIRC5 is decreased, as compared to their respective relative expression levels in a control or different bladder cancer sample, it indicates a decreased risk of progression relative to said control or different bladder cancer sample, and if the expression level for either or both UBE2C and BIRC5 is increased and the expression level for MBNL2 is decreased, as compared to their respective relative expression levels in said control or different bladder cancer sample, it indicates an increased risk of progression relative to said control or different bladder cancer sample.
 8. A method for determining the likelihood of progression of an individual's bladder cancer, comprising: determining, in a bladder tumor sample from the individual, expression levels for a signature comprising the markers MBNL2, FABP4, UBE2C and BIRC5, wherein if the expression levels for either MBNL2 or both MBNL2 and FABP4 are higher than the expression levels for either or both UBE2C and BIRC5 as compared to their respective relative expression levels in a control or different bladder cancer sample, this indicates a decreased risk of progression.
 9. A method for determining the likelihood of progression of an individual's bladder cancer, comprising: determining, in a bladder tumor sample from the individual, expression levels for a signature comprising the markers MBNL2, FABP4, UBE2C and BIRC5, wherein if the expression levels for either MBNL2 or both MBNL2 and FABP4 are lower than the expression levels for either or both UBE2C and BIRC5 as compared to their respective relative expression levels in a control or different bladder cancer sample, this indicates an increased risk of progression.
 10. A method of claim 8 wherein said signature further includes one or more of the markers COL18A1, COL4A1, ACTA2, MSN, KPNA2 and CDC25B; and wherein the expression levels are determined for all markers in the signature, whereby if the expression levels for COL18A1, COL4A1, ACTA2, MSN, KPNA2, CDC25B, BIRC5 and UBE2C are decreased relative to the expression levels for either or both MBNL2 and FABP4, as compared to their respective relative expression levels in a control or different bladder cancer sample, it indicates a decreased risk of progression relative to said control or different bladder cancer sample.
 11. A method of claim 9 wherein said signature further includes one or more of the markers COL18A1, COL4A1, ACTA2, MSN, KPNA2 and CDC25B; and wherein the expression levels are determined for all markers in the signature, whereby if the expression levels for COL18A1, COL4A1, ACTA2, MSN, KPNA2, CDC25B, BIRC5 and UBE2C are increased relative to the expression levels for either or both MBNL2 and FABP4, as compared to their respective relative expression levels in a control or different bladder cancer sample, it indicates an increased risk of progression relative to said control or different bladder cancer sample.
 12. A method of claim 6 wherein said determining of the level of gene expression in said bladder tumor sample from said individual further includes determining the expression levels of COL18A1, COL4A1, ACTA2, MSN, KPNA2 and CDC25B; wherein if the expression level for either or both MBNL2 and FABP4 is increased and the expression levels for UBE2C, COL18A1, COL4A1, ACTA2, MSN, KPNA2 and CDC25B are decreased, as compared to their respective relative expression levels in a control or different bladder cancer sample, it indicates a decreased risk of progression relative to said control or different bladder cancer sample, and if the expression levels for UBE2C, COL18A1, COL4A1, ACTA2, MSN, KPNA2 and CDC25B are increased and the expression level for either or both MBNL2 and FABP4 is decreased, as compared to their respective relative expression levels in said control or different bladder cancer sample, it indicates an increased risk of progression relative to said control or different bladder cancer sample. 